Relationship between lactose digestion, gastrointestinal transit time and symptoms in lactose malabsorbers after dairy consumption

Abstract

Background: The relationship of symptoms with objective measurements, as well as some of the mechanisms involved in lactose tolerance after yoghurt consumption, remain unclear. Methods: The trial had a double‐blind design in which 22 lactose malabsorbers received 25 g daily lactose in fresh (living bacteria > 108 cfu/g) yoghurt or heated (< 102 cfu/g) yoghurt for 15 days, followed by a cross‐over (15 days) after a wash‐out period (14 days). The lactose digestion was determined by the breath H2 test, the gastric emptying (GE) with a 13C‐acetate breath test and the revealed transit time (OCTT) by 15N‐lactose‐ureide test. Subjects reported their gastrointestinal symptoms (GIS) in a validated questionnaire. Results: Breath H2 test indicated more effective lactose digestion after fresh yoghurt intake. The OCTT was shorter after heated yoghurt ingestion as compared with the fresh. There was lower severity of GIS (P < 0.05) after fresh yoghurt intake, and this showed an inverse correlation with OCTT (P < 0.05). Conclusions: Delayed orocoecal transit time was associated with fewer gastrointestinal symptoms. The improved lactose digestion and tolerance of fresh yoghurt should be mainly attributed to the presence of living bacteria.

Acute Calcium Assimilation from Fresh or Pasteurized Yoghurt Depending on the Lactose Digestibility Status

“…The heat treatment of yoghurt to increase the shelf live of the product could diminish the effect on lactose digestibility due apparently to enzymatic inactivation [32], together with the proposed effect on orocaecal transit time, described as shorter for the pasteurized yoghurt [23]. This finding could be partially explained because calcium assimilation seems to be enhanced by lactose absorption [11].…”

“…However, calcium utilization depends upon individual factors, such as the lactase-deficiency degree as well as on food characteristics [30]. Thus, several studies have shown that yoghurt is better tolerated than milk [11], because some lactase activity from yoghurt bacteria could participate in lactose digestion, as well as the delayed oro-cecal transit time [23,31]. Therefore, yoghurt could allow lactose maldigesting people to comfortably consume a dairy food naturally rich in calcium.…”

“…The hydrogen content in breath was measured by an H 2 -specific electrochemical sensor (EC60 Gastrolyzer, Bendfont, UK), at baseline and after the lactose intake, at 15-minute intervals during four hours. The result was considered as positive when a 20ppm increment in breath hydrogen and/or symptoms were detected during the test period [23]. Volunteers with severe lactose maldigestion symptoms or discomfort were not enrolled in the trial based on ethical reasons.…”

The Impact of Probiotics on the Gastrointestinal Physiology

“…Besides colonic motility SCFA was also determined to influence upper part of digestive tract, to cause relaxation in both lower esophageal sphincter and proximal stomach and also it decreases gastric emptying time. It was explained that it showed this effect via hormonal way with the use of polypeptide YY (Labayen et al, 2001). …”

Lactose Intolerance in Infants, Children, and Adolescents

“…53,54 In addition, yogurt's semisolid state slows gastric emptying and gastrointestinal transit, resulting in fewer symptoms of lactose intolerance. 55 Furthermore, ingestion of other solid foods delays gastric emptying, providing additional time for endogenous lactase to digest dietary lactose. Aged cheeses tend to have lower lactose content than other cheeses and, thus, may also be better tolerated.…”