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(3) renal â glutamine break down in proximal tubule (combines with H+ -> NH4+ and eliminated) CAUSES OF HYPERAMMONAEMIA. Overproduction of ammonia. Protein/ amino acid load. gastrointestinal hemorrhage. gastric bypass. multiple myeloma. allogeneic stem cell transplantation.
Bacteria in the colon digest lactulose into chemicals that bind ammonia that is believed to be the toxin that causes hepatic encephalopathy. The binding of ammonia prevents ammonia from moving from the colon into the blood and also draws ammonia from the blood and into the colon.