Abstract
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.
Similar content being viewed by others
References
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, 1975
Weser E, Rubin W, Ross L, Sleisenger MH: Lactase deficiency in patients with the “irritable-colon syndrome.,” N Engl J Med 273:1070–1075, 1965
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, 1984
Welsh JD: Isolated lactase deficiencies in humans: Report on 100 patients. Medicine 49:257–277, 1970
Bose DP, Welsh JD: Lactose malabsorption in Oklahoma Indians. Am J Clin Nutr 26:1320–1332, 1973
Newcomer AD, McGill DB, Thomas PJ, Hofmann AF: Tolerance to lactose among lactase-deficient American Indians. Gastroenterology 74:44–46, 1978
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, 1978
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, 1982
Bond JH, Levitt MD: Quantitative measurement of lactose absorption. Gastroenterology 70:1058–1062, 1976
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, 1981
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, 1983
McGill DB: Diagnostic tests for lactase deficiency.In Milk Intolerance and Rejection. J Delmont (ed). Basel, S Karger, 1983, pp 35–41
Newcomer AD, McGill DB, Thomas PJ, Hoffman AF: Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med 293:1232–1236, 1975
Simoons FJ: Primary adult lactose intolerance and the milking habit: A problem in biochemical and cultural interrelations. Am J Dig Dis 14:819–836, 1969
Bayless TM, Rosenberg IH, Walker WA: When you suspect lactose intolerance. Patient Care, July 15:2–10, 1980
Woteki CE, Weser E, Young EA: Lactose malabsorption in Mexican-American Children. Am J Clin Nutr 29:19–24, 1976
Woteki CE, Weser E, Young EA: Lactose malabsorption in Mexican-American Adults. Am J Clin Nutr 30:470–475, 1977
McMichael HB, Webb J, Dawson AM: Lactase deficiency in adults. A cause of “functional” diarrhea. Lancet 1:717–720, 1965
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, 1969
Newcomer AD, McGill DB: Irritable bowel syndrome: Role of lactase deficiency. Mayo Clin Proc 58:339–341, 1983
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, 1986
Enck P, Mellibruda L, Wright E, Whitehead WE, Tucker H, Schuster MM: Manning criteria fail to distinguish IBS from lactose intolerance. Gastroenterology 86:1069, 1984
Author information
Authors and Affiliations
Additional information
The opinions and assertations expressed herein are those of the authors and are not to be construed as reflecting opinions of the United States Air Force or the Department of Defense.
Rights and permissions
About this article
Cite this article
DiPalma, J.A., Narvaez, R.M. Prediction of lactose malabsorption in referral patients. Digest Dis Sci 33, 303–307 (1988). https://doi.org/10.1007/BF01535754
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01535754