Digestive Diseases and Sciences

, Volume 33, Issue 3, pp 303–307 | Cite as

Prediction of lactose malabsorption in referral patients

  • Jack A. DiPalma
  • Roberto M. Narvaez
Original Articles


Two hundred forty-two patients referred for various gastrointestinal complaints were evaluated for clinical parameters that would predict findings of lactose malabsorption. Breath hydrogen and blood glucose lactose tests were performed after ingestion of 50 g lactose. Presenting complaints, duration of symptoms, and patient demographics such as age, sex, and ethnic heritage were not different between lactose malabsorbers and absorbers as defined by the breath hydrogen lactose test. Foodrelated symptoms in general and after specific foods such as milk, ice cream, cheese, and yogurt were also similar between groups. Prior to testing, 30% of malabsorbers (N=161) and 36% of absorbers (N=81) reported lactoserelated symptoms (P=NS). The blood glucose response to lactose was abnormal in 60% of malabsorbers and 15% of absorbers. This study confirmed our impression that it is difficult to predict lactose absorption status by clinical parameters. The majority of our lactose malabsorber patients were unaware of lactose-associated symptoms. Furthermore, symptom assessment, demographics, food history, and blood glucose testing did not predict abnormal hydrogen responses to lactose.

Key words

lactose malabsorption lactose intolerance lactose symptom awareness malabsorber prediction 


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  1. 1.
    Bayless TM, Rothfeld B, Massa C, Wise L, Paige D, Bedine MS: Lactose and milk intolerance: Clinical implications. N Engl J Med 292:1156–1159, 1975PubMedGoogle Scholar
  2. 2.
    Weser E, Rubin W, Ross L, Sleisenger MH: Lactase deficiency in patients with the “irritable-colon syndrome.,” N Engl J Med 273:1070–1075, 1965PubMedGoogle Scholar
  3. 3.
    Sciarretta G, Giacobazzi G, Verri A, Zanirato P, Garuti G, Malaguti P: Hydrogen breath test quantification and clinical correlation of lactose malabsorption in adult irritable bowel syndrome and ulcerative colitis. Dig Dis Sci 29:1098–1104, 1984PubMedGoogle Scholar
  4. 4.
    Welsh JD: Isolated lactase deficiencies in humans: Report on 100 patients. Medicine 49:257–277, 1970PubMedGoogle Scholar
  5. 5.
    Bose DP, Welsh JD: Lactose malabsorption in Oklahoma Indians. Am J Clin Nutr 26:1320–1332, 1973PubMedGoogle Scholar
  6. 6.
    Newcomer AD, McGill DB, Thomas PJ, Hofmann AF: Tolerance to lactose among lactase-deficient American Indians. Gastroenterology 74:44–46, 1978PubMedGoogle Scholar
  7. 7.
    Burgio GR, Flatz G, Barbera C, Patane R, Boner A, Cajozzo C, Flatz SD: Prevalence of primary adult lactose malabsorption and awareness of milk intolerance in Italy. Am J Clin Nutr 39:100–104, 1978Google Scholar
  8. 8.
    Ladas S, Papanikos J, Arapakis G: Lactose malabsorption in Greek adults: correlation of small bowel transit time with the severity of lactose intolerance. Gut 23:968–973, 1982PubMedGoogle Scholar
  9. 9.
    Bond JH, Levitt MD: Quantitative measurement of lactose absorption. Gastroenterology 70:1058–1062, 1976PubMedGoogle Scholar
  10. 10.
    Welsh JD, Payne DL, Manion C, Morrison RD, Nichols MA: Interval sampling of breath hydrogen as an index of lactose malabsorption in lactase-deficient subjects. Dig Dis Sci 26:681–685, 1981PubMedGoogle Scholar
  11. 11.
    Solomons NW, Hamilton LH, Christman NT, Rothman D: Evaluation of a rapid breath hydrogen analyzer for clinical studies of carbohydrate absorption. Dig Dis Sci 28:397–404, 1983PubMedGoogle Scholar
  12. 12.
    McGill DB: Diagnostic tests for lactase deficiency.In Milk Intolerance and Rejection. J Delmont (ed). Basel, S Karger, 1983, pp 35–41Google Scholar
  13. 13.
    Newcomer AD, McGill DB, Thomas PJ, Hoffman AF: Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med 293:1232–1236, 1975PubMedGoogle Scholar
  14. 14.
    Simoons FJ: Primary adult lactose intolerance and the milking habit: A problem in biochemical and cultural interrelations. Am J Dig Dis 14:819–836, 1969PubMedGoogle Scholar
  15. 15.
    Bayless TM, Rosenberg IH, Walker WA: When you suspect lactose intolerance. Patient Care, July 15:2–10, 1980Google Scholar
  16. 16.
    Woteki CE, Weser E, Young EA: Lactose malabsorption in Mexican-American Children. Am J Clin Nutr 29:19–24, 1976PubMedGoogle Scholar
  17. 17.
    Woteki CE, Weser E, Young EA: Lactose malabsorption in Mexican-American Adults. Am J Clin Nutr 30:470–475, 1977PubMedGoogle Scholar
  18. 18.
    McMichael HB, Webb J, Dawson AM: Lactase deficiency in adults. A cause of “functional” diarrhea. Lancet 1:717–720, 1965Google Scholar
  19. 19.
    Jossila J, Launiala K, Gorbatow O: Lactose deficiency and a lactose-free diet in patients with “unspecific abdominal complaints.” Acta Med Scand 186:217–222, 1969PubMedGoogle Scholar
  20. 20.
    Newcomer AD, McGill DB: Irritable bowel syndrome: Role of lactase deficiency. Mayo Clin Proc 58:339–341, 1983PubMedGoogle Scholar
  21. 21.
    Bozzani A, Penagini R, Velio P, Camboni G, Corbellini A, Quatrini M, Conte D, Blanchi PA: Lactose malabsorption and intolerance in Italians: Clinical implications. Dig Dis Sci 31:1313–1316, 1986PubMedGoogle Scholar
  22. 22.
    Enck P, Mellibruda L, Wright E, Whitehead WE, Tucker H, Schuster MM: Manning criteria fail to distinguish IBS from lactose intolerance. Gastroenterology 86:1069, 1984Google Scholar

Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Jack A. DiPalma
    • 1
  • Roberto M. Narvaez
    • 1
  1. 1.Gastroenterology ServiceWilford Hall USAF Medical CenterSan Antonio
  2. 2.Division of GastroenterologyUniversity of South Alabama Medical CenterMobile

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