Résumé
Le rôle sur le reflux gastro-œsophagien (RGO) des facteurs diététiques, y compris des aliments gras, reste controversé à l’exception de certaines boissons et divers mets épicés. D’autre part, les hydrates de carbone non digestibles ou mal digérés pourraient jouer un rôle sur le reflux via la fermentation colique. Une étude récente a montré un effet des fructo-oligo-saccharides (FOS) sur les relaxations transitoires du sphincter œsophagien inférieur, l’exposition œsophagienne acide et les scores symptomatiques de RGO. On ignore tout du rôle éventuel du lactose chez les sujets intolérants.
Les auteurs ont réalisé chez des sujets malabsorbants une étude ouverte préliminaire relative au rôle du lactose sur la sévérité des symptômes de RGO et leur consommation libre d’antiacides au cours de deux périodes respectivement avec apports élevés et limités en lactose. Pour chacun des paramètres, une différence significative entre les deux périodes a été observée. Ces résultats incitent à des investigations ultérieures contrôlées, compte tenu des la perspective d’une approche thérapeutique originale lorsque ces deux pathologies sont associées.
Summary
The role of dietary factors, even of fatty meals, on GERD remains debatable, except for some beverages and spicy foods. Conversely, indigestible carbohydrates by the way of colonic fermentation could be a responsible factor of GERD. A recent study has shown an effect of fructooligo-saccharides (FOS) on transient lower esophageal sphincter relaxations (TLESR), esophageal acid exposure and the symptom score of GERD. Nothing is known about the role of lactose in malabsorbers.
The authors performed a preliminary open study about the role of lactose on GERD symptoms severity and free consumption of antacids in lactose malabsorbers during two periods respectively with high and low lactose intake. For each parameter a significant difference between the two periods has been observed (p < 0.001). These results are calling for further investigations especially with regards to a possible original therapeutic approach when both clinical problems are associated.
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Mainguet, P., Moyersoen, A.M., Rutot, M. et al. Existe-t-il une relation entre intolérance au lactose et reflux gastro-œsophagien? Etude préliminaire. Acta Endosc 34, 305–310 (2004). https://doi.org/10.1007/BF03004259
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DOI: https://doi.org/10.1007/BF03004259