Hi, Jilly girl. I'm glad you started a new post. Nurses (and often primary care doctors) do not always know much about liver disease or how diet can make a difference. Trust me...keep the red meat away from him. He can have fish, poultry, even lean pork. Also, he may need to be on an antibiotic on a regular basis. Pink Grandma is familiar with this, as are a few others.
I know it's a difficult situation, but we are here to support you whatever the future brings.
I used to think the same thing about Lactulose. It really didn’t make my husband’s bowels move. In fact, he was constipated much of the time. As you’ve seen stated here many times, every individual is different.
When my husband was hospitalized, I complained to the hepatologist that the Lactulose just didn’t work. Of course, he increased the dosage and my husband ended up with diarrhea. They would back off the Lactulose and he would get constipated again. He was taking 30ml 3-4 times per day at the hospital. When he was extremely confused, they would administer Lactulose enemas. The whole bottle goes in!
Lactulose binds with ammonia and other toxins and draws them to the intestines. The patient must evacuate the intestines in order to get the toxins out of the system. Trust me, Lactulose works. It’s just a matter of finding the right dosage.
You may have heard of Xifaxin. It is an antibiotic that works within the intestines to control the bacteria that produce ammonia. You may want to speak with his doctor about this.
Best wishes to you. I’ve been there and done that. It is a long and difficult road.
Ask the doctor about a mild over-the-counter laxative as well. I had to give Harvey periodic doses of Dulcolax and/or prune juice to assist him. Bottom line, the ammonia must be removed from the system. If he sleeps all the time, wake him up and ensure he takes in some water. This will help stave off dehydration especially if he is on diuretics. It will help things move through his system and protect his kidneys as well.
Best of luck to you.