Interesting abstract just published on Lactose Intolerance and its relationship with Irritable Bowel Syndrome.
Clin Gastroenterol Hepatol. 2012 Dec 13. pii: S1542-3565(12)01492-9. doi: 10.1016/j.cgh.2012.11.034.
Prevalence and Presentation of Lactose Intolerance, and Effects on Dairy Product Intake, in Healthy Subjects and Patients with Irritable Bowel Syndrome.
Department of Gastroenterology, Sir Run Run Shaw Hospital affiliated to College of Medicine, Zhejiang University, Hangzhou, PR China; Department of Gastroenterology, The First People’s Hospital of Hangzhou.
BACKGROUND & AIMS:
The effects of lactase deficiency on digestive symptoms and diet in patients with irritable bowel syndrome (IBS) have not been well defined. We assessed lactose absorption and tolerance, and the intake of dairy products in healthy volunteers (controls) and patients with diarrhea-predominant IBS (D-IBS).
Sixty patients diagnosed with D-IBS at the College of Medicine, Zhejiang University, China and 60 controls were given hydrogen breath tests to detect malabsorption and intolerance following administration of 10 g, 20 g, and 40 g lactose, in random order, 7-14 days apart; participants and researchers were blinded to the dose. We assessed associations between the results and self-reported lactose intolerance (LI).
Malabsorption of 40 g lactose was observed in 93% of controls and 92% of patients with D-IBS. Fewer controls than patients with D-IBS were intolerant to 10 g lactose (3% vs 18%; OR (95% confidence interval), 6.51(1.38-30.8); P=.008), 20 g lactose (22% vs 47%; OR, 3.16 (1.43-7.02); P=.004), and 40 g lactose (68% vs 85%; OR, 2.63 (1.08-6.42); P=.03). H2 excretion was associated with symptom score (P=.001). Patients with D-IBS reported LI more frequently than controls (63% vs 22%; OR, 6.25; 95% CI, 2.78-14.0; P<.001) and ate fewer dairy products (P=.040). However, self-reported LI did not correlate with results from hydrogen breath tests.
The risk of LI is related to the dose of lactose given and intestinal gas production, and is increased in patients with D-IBS. Self-reported LI, but not objective results from hydrogen breath tests, was associated with avoidance of dairy products. ClinicalTrials.gov number: NCT01286597.
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