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Early physical symptoms of elevated blood ammonia include fatigue, muscle weakness, loss of appetite, nausea, vomiting, diarrhea, pain in the back, sides or abdomen, or other symptoms of liver and kidney damage.
The liver normally converts ammonia into urea, which is then eliminated in urine. Ammonia levels in the blood rise when the liver is not able to convert ammonia to urea. This may be caused by cirrhosis or severe hepatitis. Take enough lactulose to have 3-4 bowel movements per day and your ammonia level will drop and you will feel better.