Welcome to Connect, @peder417. I’d like to invite fellow members @adah @frankw54 @kltchrmn to join this discussion as they’ve talked about high ammonia levels as well.

The most common cause for elevated ammonia (Hyperammonemia) is liver damage and abnormal liver function. However, it can occur without liver failure, and because such occurrences are much less common, diagnosis may be missed or delayed.
– https://journals.lww.com/ccmjournal/Citation/2018/09000/Features_of_Adult_Hyperammonemia_Not_Due_to_Liver.33.aspx
– https://journals.sagepub.com/doi/full/10.1258/acb.2011.011206
@contentandwell, I do agree with you, that prompt diagnosis and appropriate intervention by seeing a liver specialist/hepatologist is especially crucial in these cases.

Lactulose is a synthetic sugar used to treat constipation. It is broken down in the colon into products that pull water out from the body and into the colon. This water softens stools. Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body. https://www.healthline.com/health/lactulose-oral-solution
I’m tagging @banzai @stella25 @gaylea1 have also written about lactulose, and I hope they will be able to share their thoughts on its use and effects.

@peder417, you might be interested in going through a few discussions on gastroparesis, where members have shared some incredible insights. Here’s one you might want to join in; feel free to share your concerns and tag members in this conversation:
– https://connect.mayoclinic.org/discussion/gastroparesis/