Bauchschmerzen, Blähbauch, Diarrhoe: Fruktosemalabsorption, Laktoseintoleranz oder Reizdarmsyndrom?

Abstract

Meteorism, abdominal spasms, diarrhea, casually obstipation, flatulence and nausea are symptoms of fructose malabsorption (FIT) and/or lactose intolerance (LIT), but are also symptoms of irritable bowel syndrome (IBS). Therefore these diseases should be considered primarily in patients with digestive complaints. For diagnosis an H(2)-breath test is used.In 1,935 patients (526 m, 1,409 f) a fructose intolerance test and in 1,739 patients (518 m,1,221 f) a lactose intolerance test was done.FIT is found more frequently than LIT (57 versus 52 % in adults (p < 0,02) and in children 90 versus 62 % (p < 0,001)) and is in polyintolerances most frequently correlated to histamine intolerance (HIT). Headache (ca. 10 %), fatigue (ca. 5 %) and dizziness (ca. 3 %) may occur after the test, irrespective whether the test was positive or negative.In more than 2/3 of patients a diet reduced in fructose or lactose may lead to improvement or remission of these metabolic disorders. IBS, which is often correlated with FIT (183/221 patients = 83 %), can be improved by relevant but also not relevant diets indicating that irritable bowel disease seems to be caused primarily by psychological disorders.

Circadian profiling reveals higher histamine plasma levels and lower diamine oxidase serum activities in 24% of patients with suspected histamine intolerance compared to food allergy and controls

“…The mere presence of gastrointestinal complaints does not allow conclusions about the genesis of the disease, although the diagnosis of an IBS is very frequently 2, 7, 30. The prevalence of IBS is significantly higher in women than in men 35.…”

“…The prevalence of the latter averages between 15% and 20% and is thus about four times higher than the prevalence of food allergy 4, 5, 6. Among the most common food intolerances are intolerances against fructose and lactose as well as histamine 4, 7. The frequency of histamine intolerance is not fully understood yet, but indirect evidence suggests that about 1%‐3% of the population is affected 8.…”

“…On the one hand, the patients' clinical presentation can resemble other food intolerances or allergy and is usually diagnosed under the umbrella of irritable bowel syndrome (IBS) 2, 7. On the other hand, histamine intolerance is also characterized by extra‐intestinal symptoms such as headache,15 pruritus,16 urticaria,17 atopic eczema,18 cardiac arrhythmia19 and asthma13, 14 that exceed the diagnosis of IBS.…”