Lactase deficiency—a comparative study of diagnostic methods

Arvanitakis, Constantine; Chen, Gran‐Hum; Folscroft, John; Klotz, Arthur P.

doi:10.1093/ajcn/30.10.1597

Cited by 23 publications

(5 citation statements)

References 15 publications

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“…Symptoms of lactose malabsorption generally occur after ingestion of 6–12 g lactose (120–240 ml of milk) (77, 78, 79). Although high doses of lactose (≥50 g) have been used for lactose breath test (80), 25 g (equivalent of 500 ml of milk) is within the normal range of consumption and is the recommended dose.…”

Section: Resultsmentioning

confidence: 99%

Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Rezaie

Buresi

Lembo

et al. 2017

American Journal of Gastroenterology

616

734

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Objectives:Breath tests (BTs) are important for the diagnosis of carbohydrate maldigestion syndromes and small intestinal bacterial overgrowth (SIBO). However, standardization is lacking regarding indications for testing, test methodology and interpretation of results. A consensus meeting of experts was convened to develop guidelines for clinicians and research.Methods:Pre-meeting survey questions encompassing five domains; indications, preparation, performance, interpretation of results, and knowledge gaps, were sent to 17 clinician-scientists, and 10 attended a live meeting. Using an evidence-based approach, 28 statements were finalized and voted on anonymously by a working group of specialists.Results:Consensus was reached on 26 statements encompassing all five domains. Consensus doses for lactulose, glucose, fructose and lactose BT were 10, 75, 25 and 25 g, respectively. Glucose and lactulose BTs remain the least invasive alternatives to diagnose SIBO. BT is useful in the diagnosis of carbohydrate maldigestion, methane-associated constipation, and evaluation of bloating/gas but not in the assessment of oro-cecal transit. A rise in hydrogen of ≥20 p.p.m. by 90 min during glucose or lactulose BT for SIBO was considered positive. Methane levels ≥10 p.p.m. was considered methane-positive. SIBO should be excluded prior to BT for carbohydrate malabsorption to avoid false positives. A rise in hydrogen of ≥20 p.p.m. from baseline during BT was considered positive for maldigestion.Conclusions:BT is a useful, inexpensive, simple and safe diagnostic test in the evaluation of common gastroenterology problems. These consensus statements should help to standardize the indications, preparation, performance and interpretation of BT in clinical practice and research.

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Section: Resultsmentioning

confidence: 99%

Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Rezaie

Buresi

Lembo

et al. 2017

American Journal of Gastroenterology

616

734

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“…Experi mental distension leads to increase in bowel motility which is larger in IBS than in normal control [95,96], Various biochemical abnor malities have been reported in IBS but their significance is unknown [97], There is an increased prevalenceoflBS in first-degree rel atives [91]. Lactose malabsorption causes similar symptoms but is an unrelated disorder [58,98].…”

Section: Irritable Bowel Syndromementioning

confidence: 99%

Psychosomatic Syndromes, Somatization and Somatoform Disorders

Kellner¹

1994

Psychother Psychosom

111

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A psychosomatic syndrome is defined as a syndrome in which psychological processes play a substantial role in the etiology of the illness in some of the patients. The main conclusions on the extent of the biological and psychosocial contributions to several psychosomatic syndromes are presented and the relationship of these syndromes to somatization and somatoform disorders is discussed. The syndromes summarized include fibromyalgia, chronic fatigue, motility disorders of the esophagus, nonulcer dyspepsia, irritable bowel syndrome, urethral syndrome, behaviors causing disturbances of physiology, and some defined pain syndromes. The findings suggest that the extent of the biological and psychosocial contributions vary among these syndromes as well as among individuals with the same syndrome. In some syndromes the extent and nature of the biological contribution has not been established with certainty. There is evidence to suggest that many of the phenomena of the somatoform disorders are caused by clustering of psychosomatic syndromes or their incomplete or atypical manifestations and a low sensation threshold. The results of the controlled studies of various methods of psychotherapy and drug treatments of the psychosomatic syndromes are listed; these studies have practical implications because the adoption of these methods is likely to enhance the efficacy of the treatment of somatoform disorders.

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“…The direct determination of the lactase activity of the small intestinal mucosa has been proposed as the reference method with which all indirect diagnostic methods should be compared [28][29][30][31]. A low jejunal lactase activity is always present in hypolactasia.…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Hypolactasia (Lactase Restriction) - A Normal Condition for the Adult

Arola¹

1989

Dig Dis

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Lactase deficiency—a comparative study of diagnostic methods

Cited by 23 publications

References 15 publications

Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Psychosomatic Syndromes, Somatization and Somatoform Disorders

Hypolactasia (Lactase Restriction) - A Normal Condition for the Adult

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