A Diagnostic Approach to Patients with Suspected Lactose Malabsorption

Abstract

The LBT may serve as a diagnostic screening tool for lactose malabsorption. Symptomatic patients with negative LBT results should be referred for second-line testing with the LIQT.

Lactose malabsorption in systemic sclerosis

“…Lactose malabsorption may be due to many conditions, including: congenital lactose deficiency; lactase nonpersistence, in which lactase production declines over time, often begining at about age 2 years and secondary lactase deficiency, which results from injury to the small intestine. Secondary lactase deficiency has been found in various gastrointestinal conditions including coeliac disease, Crohn's disease, infectious enteritis, SIBO, irritable bowel syndrome, radiation enteritis, gastrointestinal surgery and short bowel syndrome …”

“…Furthermore, in this instance, the collection of breath samples was performed according to previous methodological recommendations to ensure end‐alveolar breath samples . We measured both H2 and CH4 levels, as it has been shown that false negative findings are observed in 16% of cases when CH4 is not measured …”

“…Thus, lactose breath test has the advantage of evaluating the total lactase activity. Furthermore, many series have recently demonstrated that there is an excellent concordance between lactose malabsorption on lactose breath test and hypolactasia on the biopsy‐based lactose intolerance quick test (LIQT) . Unfortunately, the LIQT is still unavailable in our tertiary care centre.…”

“…In non‐SSc patients, lactose malabsorption has been reported to result in abdominal clinical manifestations, including pain, bloating, borborygmi, nausea/vomiting and/or diarrhoea . In clinical practice, lactose breath test represents a noninvasive and reliable method to depict lactose malabsorption with both high sensitivity, specificity and positive predictive value …”

Clinical evaluation, biochemistry and genetic polymorphism analysis for the diagnosis of lactose intolerance in a population from northeastern Brazil

“…Other studies have proposed a flow chart, but biochemical blood testing following lactose ingestion and glucose level measurement are rarely evaluated 6 , 31 . Here, we present a diagnostic algorithm for LI, considering biochemical blood test results, clinical symptoms, and genotyping of the SNPs C>T -13910 and G>A -22018 .…”