Nit major, but am keenly aware if my ammonia etc is off. Off balance, confused and almost a “ stoned-like” feeling. I do not play with this. I feel it, I get answers. Or do what I know works like more lactulose. There are other meds avail as well . Ziavaxin(sp) that assist lactulose effectiveness. Talk to doctors.

I am also on zifaxin and have taken lactulose. I was recently hospitalized after my husband and mom tried to care for me at home for 2 weeks. Was only in hospital for 5 days. Ive lost about 3 months of memories. Definitely nothing to play around with. 👍