A theoretical hazard may exist for patients treated with lactulose syrup who may be required to undergo electrocautery procedures during proctoscopy or colonoscopy if sugars reach the colon then bacterial breakdown causes hydrogen production. Accumulation of hydrogen gas in significant concentration in the presence of an electrical spark may result in an explosive reaction. Although this complication has not been reported with lactulose, patients on lactulose therapy undergoing such procedures should have a thorough bowel cleansing with nonfermentable solution.
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