What is moderan?
The moderan is the commercial name of asynthetic sugardistributed in Spain and other countries. The word “synthetic sugar” refers to the fact that themain componentof the drug is a carbohydrate, created in a laboratory.
Note: It is mainly usedfor constipation, as a prophylactic (preventive) treatment in certain liver diseases, which generate increased ammonia in the blood.
Composition
The active ingredient, that is, the substance that makes the action of the drug, islactulose. Each 15 ml contains 10 g of lactulose.
Fun fact: Lactulose isa carbohydrate that cannot be absorbedin the small intestine, first created in 1929, marketed worldwide in 1950, and is part of the list of essential medicines of theWorld Health Organization.
Presentations and dosage
The moderatorhas an oral presentation. It is acolorless or yellowish solution, which comes in bottles of 237 ml or 946 ml. It also has a rectal form, as an enema, and in the form of crystals that must be diluted in water.
Regarding the dose, two tablespoons of moderate per day is generally recommended, that is, 15 to 30 ml containing 10 g and 20 g of lactulose, respectively. For patients under 14 years of age, the dose changes.
For example, a child between the ages of 7 and 14 only needs 20 g of lactulose per day. On the other hand, those under 6 years of age will only be able to consume up to 10 g of it.
Since it is a sugar, Moderan syrup can be too sweet and cloyingfor some people. Therefore, it can be mixed with other drinks, such as fruit juices or just water, to attenuate the excessive sweet taste.
Important:Its intake is recommended while symptoms of constipation or risk of elevated ammonia are still present. Consuming these laxatives for months, without any need, increases the risk of unwanted effects.
What is moderan indicated for?
Lactulose is used to treat gastrointestinal problems , ranging from constipation to liver problems. Next, we will explain some of its functions.
Constipation
Lactulose is a sugar that, since it is not broken down and absorbed in the small intestine, reaches the colon virtually intact. Thereit exerts an osmotic effecttag. What does this mean? That lactulose draws water from our body into the colon.
This achieves the softening of the stool, facilitating intestinal transit and reducing the sensations of discomfort or pain that the person may present during defecation.
Reduction of ammonia in the blood
Ammonia is the metabolic residue, which is produced during the degradation of proteins in our body, to obtain the amino acids of which the protein is composed.
Under certain conditions, such as liver damage from hepatitis B or C, cirrhosis, severe alcoholism, or chronic liver failure, hyperammonemia can occur , which is highly toxic (particularly to the central nervous system ).
Lactulose works well against this symptom, since it traps ammonia in the intestine, which allows its excretion. It is frequently used to preventHepatic encephalopathy.
Note: The word “hyperammonemia” literally means “excess ammonia in the blood.”
Moderate contraindications
Allergy to components
If you have Allergy Symptoms such as hives, difficulty breathing, swelling of the face, lips, tongue, or throat, you may be allergic to lactulose.
To highlight: In a case report published in the Annals of Allergy, Asthma & Immunology, it was described how a 4-year-old boy presented symptoms of an allergic reaction, moments after being administered lactulose to treat his constipation. (1)
obstructed intestines
Important: The prolonged use of these laxatives for months can also increase the risk of intestinal obstruction , since they increase the total mass of the stool, which can be compacted.
Galactosemia
It is a metabolic and genetic disease , where the individual’s ability to metabolize galactose is altered, causing symptoms such as lethargy, vomiting, diarrhea and even jaundice.
But what does it have to do with lactulose? Because it is artificially created in laboratories from lactose, a sugar in turn made up ofglucose and galactose.
Therefore, use of this medication should be avoided, since it can induce all kinds of adverse reactions in the person, such as stomach upset or vomiting.
moderate side effects
Like all osmotic laxatives, they have side effectsthat, although they are not lethal at all, can be uncomfortable for the person. Next, we will explain them.
Abdominal pain
The relationship between Distension of the Colonic Viscera , abdominal pain and gas formation is a subject of active research, so only hypotheses exist.
To highlight: In an article published in the Journal of Neurogastroenterology and Motility , some pathophysiological mechanisms are compiled, such as: the accumulation of gases, an autonomic dysfunction that causes hypersensitivity of the viscera, alteration of the microbial flora of the intestine, transit disorders intestine and evacuation. (two)
Abdominal distension
Upon reaching the colon, lactulose is metabolized by bacteria living in the large intestine to simple sugars, known as monosaccharides.
The high activity of the bacteria when breaking down this sugar releases gases, such as hydrogen and methanol, causing distension of the viscera due to the accumulation of said gases.
Note: This bloating may be accompanied by feelings that have been described as “heavy”, “uncomfortable” or “full”.
Diarrhea and gas
Since the colon is full of gases, the body seeks to relieve this pressure caused by them, which can be embarrassing or uncomfortable for the person in certain situations.
Diarrhea, on the other hand, can be due to excessive use of laxatives or the prolonged use of these over the months, since they increase the volume of feces and the number of evacuations.
This diarrhea can lead to other problems, such as dehydrationtag. In addition, moderan works by changing electrolyte concentrations in the intestine, which allows water to be drawn from the body to the colon.
This can lead to electrolyte disturbances, such as hypernatremia or hypokalemia.
Tip: To avoid dehydration or loss of electrolytes, it is important to stay hydrated, not only to improve your intestinal transit and help soften your stool, but to avoid these problems.
Key Findings
- The main component of moderan is Lactulose , a synthetic sugar with an effective osmotic action.
- Lactulose modifies electrolyte concentrations in the colon, drawing water into the stool, softening it and increasing its volume.
- People who suffer from lactose intolerance , with galactosemia, or intestinal obstruction should not take this medication.
- There are adverse effects, such as excessive flatulence, abdominal distension or diarrhea.
- You must stay hydrated , to counteract the loss of fluid and electrolytes.
University Professional in the area of Human Resources, Postgraduate in Occupational Health and Hygiene of the Work Environment, 14 years of experience in the area of health. Interested in topics of Psychology, Occupational Health, and General Medicine.