Subjective Perception of Lactose Intolerance Does Not Always Indicate Lactose Malabsorption

Casellas, Francesc; Aparici, Anna; Aurrekoetxea-Casaus, Maite; Rodríguez, P.; Malagelada, Juan R.

doi:10.1016/j.cgh.2010.03.027

Cited by 65 publications

(51 citation statements)

References 25 publications

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“…La frecuencia de IL en esta muestra de pacientes sintomáticos (52,5%) resultó muy similar al 56% esperado para población hispánica (mestiza) chilena escasa utilidad para seleccionar pacientes con NPL y MAL, como ha sido repetidamente reportado en la literatura 15,18,19 . En la práctica clínica habitual los síntomas asociados a la ingesta de leche pueden atribuirse a NPL, a TDF o a una mezcla de ambos.…”

Section: Discussionunclassified

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Diagnóstico de intolerancia a la lactosa en adultos: rendimiento comparativo de la clínica, test de hidrógeno espirado y test genético

et al. 2012

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Section: Discussionunclassified

“…Comparados con población sana, la IL es más frecuente en sujetos con TDF, mientras que la frecuencia de NPL es la misma. Existe poca correlación entre los síntomas y el resultado de métodos diagnósticos objetivos 15 . Los principales métodos diagnósticos para detectar IL se resumen en la Tabla 1.…”

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Diagnóstico de intolerancia a la lactosa en adultos: rendimiento comparativo de la clínica, test de hidrógeno espirado y test genético

et al. 2012

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“…7 Strategies to reduce unpleasant gastrointestinal symptoms associated with lactose intolerance include (1) choosing lactose-free or reduced-lactose dairy foods, [8][9][10][11] (2) choosing fermented dairy foods, [11][12][13] (3) combining lactose intake with a meal, [14][15][16] (4) taking lactase enzyme tablets, 10,11,17 (5) consuming probiotics, 11,[18][19][20] (6) colonic adaptation, [21][22] and (7) psychological and behavioral approaches. [23][24][25] None of these strategies, however, have been shown to fully eliminate symptoms. A recent review by the NIH highlighted the need for further studies evaluating the effectiveness of interventions addressing lactose intolerance.…”

Section: Introductionmentioning

confidence: 99%

Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study

Mummah

Oelrich

Hope

et al. 2014

The Annals of Family Medicine

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PURPOSE This pilot study aimed to determine whether raw milk reduces lactose malabsorption and/or lactose intolerance symptoms relative to pasteurized milk. METHODSWe performed a crossover trial involving 16 adults with self-reported lactose intolerance and lactose malabsorption confirmed by hydrogen (H 2 ) breath testing. Participants underwent 3, 8-day milk phases (raw vs 2 controls: pasteurized, soy) in randomized order separated by 1-week washout periods. On days 1 and 8 of each phase, milk consumption was 473 mL (16 oz); on days 2 to 7, milk dosage increased daily by 118 mL (4 oz), beginning with 118 mL (4 oz) on day 2 and reaching 710 mL (24 oz) on day 7. Outcomes were area under the breath H 2 curve (AUC ∆H 2 ) and self-reported symptom severity (visual analog scales: flatulence/gas, audible bowel sounds, abdominal cramping, diarrhea).RESULTS AUC ∆H 2 (mean ± standard error of the mean) was higher for raw vs pasteurized on day 1 (113 ± 21 vs 71 ± 12 ppm·min·10 -2 , respectively, P = .01) but not day 8 (72 ± 14 vs 74 ± 15 ppm·min·10 -2 , respectively, P = .9). Symptom severities were not different for raw vs pasteurized on day 7 with the highest dosage (P >.7). AUC ∆H 2 and symptom severities were higher for both dairy milks compared with soy milk.CONCLUSIONS Raw milk failed to reduce lactose malabsorption or lactose intolerance symptoms compared with pasteurized milk among adults positive for lactose malabsorption. These results do not support widespread anecdotal claims that raw milk reduces the symptoms of lactose intolerance. INTRODUCTIONL actose malabsorption is an extremely common condition worldwide, and its incidence increases with age and varies between ethnicities. 1,2 Bacteria in the colon ferment undigested lactose into short-chain fatty acids, hydrogen, methane, and carbon dioxide, resulting in such symptoms as bloating, abdominal pain, and/or diarrhea after ingestion of lactose. 1 National Institutes of Health (NIH) consensus development panel defined lactose intolerance as a clinical syndrome characterized by the onset of gastrointestinal symptoms following a lactose challenge, 3 whereas true lactose malabsorption is identified through a hydrogen breath test (HBT). Many people with lactose malabsorption do not report clinical lactose intolerance. 4,5 Conversely, many individuals with perceived lactose intolerance do not experience malabsorption. 6 Because of inconsistent definitions in previous studies, the true prevalence of lactose intolerance is unknown. 7Strategies to reduce unpleasant gastrointestinal symptoms associated with lactose intolerance include (1) choosing lactose-free or reduced-lactose dairy foods, [8][9][10][11] (2) choosing fermented dairy foods, 11-13 (3) combining lactose intake with a meal, [14][15][16] (4) taking lactase enzyme tablets, 10,11,17 (5) consuming probiotics, 11,[18][19][20] (6) colonic adaptation, [21][22] and (7) 135NIH highlighted the need for further studies evaluating the effectiveness of interventions addressing lactose intolerance. 3,7 Rece...

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“…Survey shows that people commonly combined the ingestion of lactose with intestinal ailments, including mainly the occurrence of abdominal pain, even in the absence of evident hypolactosis data (negative HBT test) [15,16,17,18,19]. Symptoms often regarded as NL are secondary to motor disorders of the gastrointestinal tract [15,20,21,22,23,24]. Presence of other diseases of the gastrointestinal tract can not be excluded [25,26,27].…”

Section: Discussionmentioning

confidence: 99%

Symptoms occurring after consuming milk among children, youth and students with hypolactasia

2017

IJND

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Subjective Perception of Lactose Intolerance Does Not Always Indicate Lactose Malabsorption

Cited by 65 publications

References 25 publications

Diagnóstico de intolerancia a la lactosa en adultos: rendimiento comparativo de la clínica, test de hidrógeno espirado y test genético

Diagnóstico de intolerancia a la lactosa en adultos: rendimiento comparativo de la clínica, test de hidrógeno espirado y test genético

Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study

Symptoms occurring after consuming milk among children, youth and students with hypolactasia

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