It is a sugar which is chemically related to milk sugar, lactose. The difference is that it is not absorbed at all.Therefore, it creates an osmotic gradient in the bowel lumen forcing water to enter the lumen which, in turn, induces a bowel movement.
I beleive that yes when it reach the lower bowel.In the first hours,it seems to "help" by creating gas induced BM.But i took chocolate in the afternoon.So normally i don't get this bad feeling with chocolate alone,so yes,the Lactulose seems to cause pain and gas.Especially when it get trapped down there.
I have been on this... as flux said it's an osmotic laxative so it is safe for long term use. I personally found although it helped ( a lot at first, and then not a lot later), I also suffered increased cramps, and terrible wind, and so I came off it.
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