Intestinal Lactase Deficiency in Ceylon (Sri Lanka)

Senewiratne, B.; Thambipillai, Shanthi; Perera, H. A. C. R.

doi:10.1016/s0016-5085(77)80022-x

Cited by 21 publications

(7 citation statements)

References 25 publications

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“…Third, a higher background of intestinal infection and related reduced surface area of the small bowel (shorter villi) may influence bowel physiology. Fourth, there is a very high rate of lactose malabsorption in many of the South Asian countries including Sri Lanka …”

Section: Irritable Bowel Syndrome In South Asiamentioning

confidence: 99%

“…In a region where nutritional adequacy is a challenge to achieve because of food availability and with high proportions of the population being vegetarians, avoidance of FODMAP‐rich foods might further compromise nutritional adequacy unless alternatives were readily available. Lactose is one example of a FODMAP that may be commonly contributing to gastrointestinal symptoms in the South Asian population as the prevalence of lactose malabsorption is high . Because lactose‐free milk is not freely available in South Asia and is not affordable to most, exclusion of lactose‐containing dairy products presents as a major challenge to the nutritional adequacy of the diets especially in lacto‐vegetarians and should be carried out only if the patients are markedly troubled by their symptoms.…”

Section: Applicability Of Fodmap Principles To South Asia and Its Impmentioning

confidence: 99%

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Dietary practices and FODMAPs in South Asia: Applicability of the low FODMAP diet to patients with irritable bowel syndrome

Hewawasam

Iacovou

Muir

et al. 2018

J of Gastro and Hepatol

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The low Fermentable Oligosaccharides, Disaccharides, and Monosaccharides And Polyols (FODMAP) diet has been described, evaluated, and found efficacious for the treatment of patients with irritable bowel syndrome primarily in Western countries. The aim of this review was to address the applicability of this diet to South Asia. The high prevalence of irritable bowel syndrome in South Asia and its associated effects of quality of life and economics warrant the introduction of efficacious therapies. The considerable heterogeneity of dietary patterns and methods of food preparation across South Asian countries and a paucity of food analysis limit precision in defining foods that are high or low in FODMAPs. Spices and condiments are commonly consumed and mostly have a low FODMAP content. However, major high FODMAP sources are frequently used and include onion, garlic, shallots, legumes/pulses, and wheat‐based products, as well as coconut and milk products, offering an opportunity for dietary management to reduce the symptom load. The feasibility of instituting a restrictive diet in which foods with a high FODMAP content are replaced by foods low in FODMAPs must be addressed as a substantial proportion of the nutritional intake including energy, proteins, and micronutrients, is often obtained from FODMAP‐rich food. Furthermore, limited knowledge of health professionals together with a paucity of dietitians further challenge the practicality of introducing the diet. Thus, while the use of the low FODMAP diet in South Asia may be more limited than in westernized countries, it does offer potential therapeutic opportunities, the efficacy, and impact of which require further investigation.

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Section: Irritable Bowel Syndrome In South Asiamentioning

confidence: 99%

Section: Applicability Of Fodmap Principles To South Asia and Its Impmentioning

confidence: 99%

Dietary practices and FODMAPs in South Asia: Applicability of the low FODMAP diet to patients with irritable bowel syndrome

Hewawasam

Iacovou

Muir

et al. 2018

J of Gastro and Hepatol

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“…These may give rise to symptoms often associated with lactose intolerance, which ranges from 12.6% in Bangladesh to 70%-100% in other countries. 41,42 IBS patients in the Middle East often are convinced that their abdominal symptoms are related to food and eating, whereas diet in Israel is associated with a prevalence of bloating and flatulence.…”

Section: Food and Food Taboosmentioning

confidence: 99%

Multicultural Aspects in Functional Gastrointestinal Disorders (FGIDs)

et al. 2016

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“…There is a high prevalence of lactase deficiency in many Asian countries ranging from 70% to nearly 100%. 57,58 Yet, in Sri Lanka when 145 subjects with lactase deficiency were fed 50 g lactose, equivalent to four glasses of milk, only one-third reported symptoms. 57 In Bangladesh lactose intolerance was reported by 12.6% of IBS subjects, no more than that reported among non-IBS subjects.…”

Section: Pathogenetic Mechanismsmentioning

confidence: 99%

“…57,58 Yet, in Sri Lanka when 145 subjects with lactase deficiency were fed 50 g lactose, equivalent to four glasses of milk, only one-third reported symptoms. 57 In Bangladesh lactose intolerance was reported by 12.6% of IBS subjects, no more than that reported among non-IBS subjects. 36 Postinfectious IBS An episode of infectious gastroenteritis is now recognized as a strong risk factor for the development of IBS.…”

Section: Pathogenetic Mechanismsmentioning

confidence: 99%

Irritable bowel syndrome in developing countries – a disorder of civilization or colonization?

2005

Neurogastroenterology Motil

167

139

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While irritable bowel syndrome (IBS) is common in the West, early studies suggest that the prevalence is low in developing countries. However, recent studies point to increasing prevalence in newly developed Asian economies. The presentation appears to differ from the West, with a lack of female predominance, a greater frequency of upper abdominal pain and defecatory symptoms perceived as being less bothersome. This difference, together with the preoccupation with organic disease, could explain why we may be missing IBS in Asia and also why excess surgery has been observed in some Asian countries. While a recent study from China, consistent with western studies, support an important role for infection and inflammation, early studies from India reporting no association between amoebic infection and IBS appear to dispute this observation. To reconcile these seemingly contradictory observations, an hygiene hypothesis model is proposed. Exposure to a variety of microorganisms early in life could result in the colonization of the intestine with microflora that can respond more efficiently to an episode of gastroenteritis. Together with the changes with evolution of Asian economies such as westernization of the diet and increased psychosocial stress, it is proposed that loss of this internal protective effect, could give rise to a more uniform worldwide prevalence of IBS.

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Intestinal Lactase Deficiency in Ceylon (Sri Lanka)

Cited by 21 publications

References 25 publications

Dietary practices and FODMAPs in South Asia: Applicability of the low FODMAP diet to patients with irritable bowel syndrome

Dietary practices and FODMAPs in South Asia: Applicability of the low FODMAP diet to patients with irritable bowel syndrome

Multicultural Aspects in Functional Gastrointestinal Disorders (FGIDs)

Irritable bowel syndrome in developing countries – a disorder of civilization or colonization?

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