The incidence of adult type hypolactasia in patients with irritable bowel syndrome

Abstract

Introduction The incidence of lactose intolerance in irritable bowel syndrome (IBS) varies in the literature (27–72%). Primary adult lactase deficiency (adult type hypolactasia) is the most common type of primary enzyme deficiency. Complaints related to lactose intolerance may overlap with the symptoms of IBS. Aim To assess the prevalence of primary hypolactasia in patients with IBS. Material and methods The study included 56 patients with IBS diagnosed based on the Rome III criteria and 23 healthy people. All study participants completed a questionnaire on IBS symptoms and lactose intolerance, and they underwent a hydrogen breath test (HBT) with lactose. In the group of patients with positive results of HBT, the polymorphism C/T -13910 and G/A -22018 in the promoter of the LCT gene encoding lactase was determined. Results Lactase deficiency was diagnosed in HBT in 34 (60.7%) patients with IBS and in the control group – in 10 (43.5%). Primary adult type hypolactasia was confirmed in 78.9% ( n = 30; 79.3% in the study group; 77.8% in the control group). There were no statistically significant differences in the occurrence of LCT gene polymorphisms in particular IBS subtypes. Adult type hypolactasia was significantly more common in patients with severe than moderate and mild enzyme deficiency in HBT ( p < 0.05). Conclusions The incidence of lactase deficiency in IBS patients is not different from that found in healthy subjects. Nevertheless, irrespective of the IBS subtype, lactose intolerance may pose additional issues in patients with IBS and requires the targeted treatment.

Lactase Deficiency and Lactose Intolerance: Current Understanding and Future Directions

“…This is supported by the observation that more than 90% of the population in Scandinavian countries and the Netherlands, where the consumption of milk and its products is significant and long-lasting, have high lactase activity, in contrast to countries in Asia or most areas of Africa, where the frequency is about 10% [3,4]. In Europe, 2 polymorphisms of the LCT gene are responsible for reduced lactase production: C/T-13910 and G/A-220186 [5]. The TT and AA variants are dominant and determine the maintenance of lactase at high levels in adults, while the CC and GG variants are responsible for the formation of adult-type hypolactasia.…”

Cow’s Milk: A Benefit for Human Health? Omics Tools and Precision Nutrition for Lactose Intolerance Management

“…In a preliminary study, Kowalówka et al observed that young Polish adults with polymorphic variant −13910:C>T showed lower levels of vitamin D and calcium in LNP subjects compared with those with the −13910:T>T variant [117]. Moreover Dom żał-Magrowska et al, based on the results of the hydrogen breath test, observed no statistically significant differences between IBS patients who had the −13910:C>T and −22018:G>A polymorphism compared with the control group reporting hypolactasia [118].…”

Cow’s Milk: A Benefit for Human Health? Omics Tools and Precision Nutrition for Lactose Intolerance Management

“…In a preliminary study, Kowalówka et al observed that young Polish adults with polymorphic variant −13910:C>T showed lower levels of vitamin D and calcium in LNP subjects compared with those with the −13910:T>T variant [ 117 ]. Moreover Domżał-Magrowska et al, based on the results of the hydrogen breath test, observed no statistically significant differences between IBS patients who had the −13910:C>T and −22018:G>A polymorphism compared with the control group reporting hypolactasia [ 118 ].…”