Ammonia on the brain

My brother has been diagnosed with end stage liver disease. He has had the acitis on his abdomen, swollen feet and is not able to function without the assistance of someone to help with walking, sometimes eating and severe confusion. He has been in the hospital 3 times in the last month with high ammonia levels. He was just told he needed to be on a no protein diet and is taking the lactulose. The last time he was in the hospital his ammonia level was 250. He was not responding to anyone and it mimicked a stroke. He received IV therapy and a blood transfusion at this time also. Would increasing his lactulose on the onset of increased confusion (he is always slightly confused now) help clear some more of the ammonia out? Could my mother adjust the dose herself or is this something only the doctor should be doing at this point?

[carbar7730]

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