What is the therapeutic effect of lactulose?

A. Reduced triglyceride levels: Lactulose does not influence lipid metabolism or serum triglycerides. Its mechanism of action is focused on the gastrointestinal tract and ammonia elimination, not cardiovascular or metabolic parameters. B. Reduced blood ammonia levels: Lactulose is a nonabsorbable disaccharide that is metabolized by colonic bacteria into acids, lowering intestinal pH. The acidic environment converts ammonia (NH₃) to ammonium (NH₄⁺), which is less readily absorbed, promoting excretion and lowering systemic blood ammonia. This effect is particularly important in hepatic encephalopathy. C. Reduced intracranial pressure: Lactulose does not directly alter cerebrospinal fluid dynamics or intracranial pressure. Any improvement in neurologic status is secondary to decreased ammonia levels rather than a direct effect on ICP. D. Reduced episodes of watery stool: Lactulose can cause osmotic diarrhea as part of its mechanism, rather than reducing diarrhea. Its stool-softening effect is intended to facilitate ammonia excretion rather than manage stool frequency in other contexts.