@banzai When I had cirrhosis, prior to my transplant, I too was cold and tired all of the time. I would wear flannel pajamas to bed with a fleece jacket on. Those are both symptoms of cirrhosis. Also, diabetes is pretty common with cirrhosis. I was diagnosed with diabetes long before I was diagnosed with cirrhosis. When I was finally was diagnosed with cirrhosis I was told by a hepatologist that I probably had it for about 10 years, it takes a while to announce itself. If you are not seeing a hepatologist you should try to.

Lactulose always upset my stomach too. Diluting it with some flavored soda water helped it to go down easier. I was on just xifaxan for a while and that had no bad effects for me. As my cirrhosis progressed I had to resume taking lactulose along with xifaxan. It's a necessary evil and the diarrhea is actually an intended effect to get the toxins out of your system to prevent hepatic encephalopathy episodes (HE). It is one of the very few drugs that the patient has to titrate themselves to achieve 3 - 4 soft bowel movements a day. If you are having more diarrhea than that ask your doctor -- he or she will probably tell you to decrease the amount you are taking.
JK