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Introduction: Diagnosing lactose malabsorption is usually based on hydrogen excretion in breath after a lactose challenge. However, a proportion of subjects with lactose malabsorption will not present a rise in hydrogen. Measuring excretion of methane or stable isotope labeled 13CO2 after ingestion of 13C-lactose has been proposed to mitigate this problem. Objective: The aim of the study was to assess the performance of measuring methane and 13CO2 in individuals with normal hydrogen excretion compared to a genetic lactase non-persistence test. Methods: Individuals referred for lactose breath testing and healthy controls were included. Participants received 13C-enriched lactose, performed breath testing, and underwent genotyping for a marker of lactase non-persistence (13910C*T). Using genotype as gold standard, the performance of measuring methane and 13CO2 excretion was assessed. Results: 151 subjects participated in the study, 50 of which presented a lactase non-persistent genotype. Of these, 72% were correctly diagnosed through hydrogen excretion of ≥ 20 ppm above baseline. In subjects with normal hydrogen excretion, cumulative 13C excretion had an area under the curve (AUC) of the receiver operating characteristics (ROC) curve of 0.852. Sensitivity was 93% and specificity was 51% for the current cutoff of 14.5%. The optimal cutoff was 12.65% (sensitivity 93%, specificity 70%). The ROC curve of peak methane had an AUC of 0.542 (sensitivity of 14%, specificity of 91% for cutoff ≥ 10 ppm). Conclusions: In individuals with genetically demonstrated lactase non-persistence and negative hydrogen breath test, the use of 13C-lactose with measurement of 13CO2 excretion and hydrogen is a well-performing test to detect the lactose malabsorption and performs better than methane in our cohort. [ABSTRACT FROM AUTHOR]

Background. Insufficient vitamin D and calcium intake associated with the restricted intake of milk and dairy products can lead to poor health outcomes like malnutrition and abnormal bone mineralization. The aim of the study was to estimate the prevalence of primary and secondary lactose intolerance in children with IBD. Methods. The study included 107 patients (mean age 14.07±3.58 years; 46.7% boys) which includes 43 patients with Crohn's disease (CD), 31 with ulcerative colitis (UC), and 33 children with functional abdominal pain (AP-FGID). We analysed the result of the hydrogen breath test with lactose loading, two single nucleotide polymorphisms of the LCT gene (LCT-13910CC and LCT-22018GG). The results were analysed with MedCalc Statistical Software. Results. Adult-type hypolactasia (ATH) was found in 31% of patients with IBD and 42.4% of AP-FGID (p=0.2). Lactose malabsorption (LM) was found in 27.9% of patients with CD, in 22.6% with UC, and in 24.2% with AP-FGID (p=0.8). Lactose intolerance (LI) was diagnosed in a similar percentage of patients in each group (p=0.9). Secondary LI in IBD patients does not depend on the location, duration, and activity of the disease and the number of relapses (p>0.05). The median time of lactose-free diet in CD was 10 months and in CU 24 months. Conclusions. The incidence of LI, LM, and ATH does not differ among children with IBD from the population. [ABSTRACT FROM AUTHOR]

Background: Current literature proposes associations between homocysteine (HCY), folic acid (FA), vitamin B12 metabolism and depression. However, the exact underlying biological mechanisms remain unclear. This study aimed at evaluating a possible link between primary adult-type lactose malabsorption (PALM), HCY, FA and vitamin B12 metabolism and depressive disorder. Methods: Plasma levels of HCY, FA and vitamin B12 were determined in 78 patients with PALM and 160 individuals with lactase persistence sub-grouped by the presence or absence of major depression. Results: In 78 patients with PALM, the subgroup of 22 individuals with major depression showed significantly higher median (interquartile range) HCY (10.10 [8.46–12.03] vs. 8.9 [7.54–9.86] μmol/L, p = 0.029) and lower plasma FA levels (5.7 [4.68–9.14] vs. 6.95 [5.24–10.56] μmol/L, p = 0.272) compared to the subgroup of 56 individuals without depression, respectively. No such associations could be observed for those 160 individuals without PALM (i.e., lactase persistence) Plasma HCY levels were positively correlated with depressive symptoms (p = 0.052), and showed negative correlations with FA (p = < 0.001) and vitamin B12 (p = 0.029), respectively. Conclusion: Depressed individuals with PALM were found with significantly higher HCY and lower FA levels compared to non-depressed individuals with PALM, however, this association was absent in the subgroup of lactase persistent individuals. These findings suggest an association between increased HCY levels, lactose malabsorption and depression. [ABSTRACT FROM AUTHOR]

Abstract: Background: Lactose intolerance is a frequent condition in certain populations. Different methods for diagnosis exist. There is scarce literature regarding Lactose Quick Test (LQT) and concordance with other methods for lactose intolerance diagnosis in children. Methods: Prospectively, we included children who underwent gastroduodenoscopy for evaluation of abdominal pain. We obtained a duodenal sample for LQT and blood sample for genetic test to evaluate LCT C>T‐13910 variant. Later, patients underwent breath test with lactose, to evaluate malabsorption. We evaluated the concordance between the three different tests. Key Results: We included 46 patients, 56.5% women. Mean age was 13.2 years (range 9‐18 years). 66.6% of patients had lactose malabsorption according to breath test; 64.4% were homozygous CC; and 91.3% had hypolactasia (mild or severe) according to LQT. None of the patients with normolactasia had altered breath test. Genetic test had a substantial agreement (k = 0.675) with breath test and fair agreement (k = 0.301) with LQT. LQT had fair agreement (k = 0.348) with breath test. Conclusions & Inferences: Genetic test had better concordance with breath test than LQT to diagnose lactose malabsorption, however, none of the patients with normal LQT had lactose malabsorption. In patients who undergo gastroduodenoscopy to study abdominal pain, it seems reasonable to perform LQT, and, in those with hypolactasia, to perform breath test. [ABSTRACT FROM AUTHOR]

Objectives Recently, an intermediate lactose intolerance (LI) phenotype based on the lactase gene ( LCT ) C/T -13910 polymorphism was proposed. However, a multifactorial genesis of LI phenotypic variation including endogenous and exogenous factors cannot be ruled out. Therefore, this study was conducted to investigate a possible association between serum diamine oxidase (DAO) and LI phenotypes in individuals with lactose malabsorption (LM). Design and methods A total of 121 ambulatory patients with LM were included in this retrospective study. The lactose hydrogen breath test (LHBT) and serum DAO activity measurements were performed on the same day. A thorough anamnesis with respect to gastrointestinal symptoms was carried out at the initial consultation. Results In total, 44 (36.4%) patients with a serum DAO activity < 10 U/mL showed higher H 2 levels after 60 (mean: 53.7 ± 57.6 vs 34.5 ± 31.7 parts per million [ppm], p = 0.116), 90 (mean: 70.3 ± 57.5 vs 52.7 ± 41.4 ppm, p = 0.184) and 120 min (mean: 98.9 ± 72.5 vs 67.9 ± 44.9 ppm, p = 0.012) during LHBT compared to 77 (63.6%) patients with a serum DAO activity ≥ 10 U/mL. Individuals with a serum DAO activity < 10 U/mL tended to report gastrointestinal symptoms during the LHBT more often ( p = 0.091). Conclusions Our findings suggest that patients with LM and a serum DAO activity level < 10 U/mL had higher end-expiratory H 2 levels and tended to be more symptomatic during the LHBT compared to LM patients with DAO activity levels ≥ 10 U/mL. [ABSTRACT FROM AUTHOR]

Background: Adult lactase non-persistence (LNP) is due to low lactase expression, resulting in lactose malabsorption (LM). LNP is a genetic trait, but is typically determined by LM markers including breath H2, blood glucose, and urinary galactose after a lactose tolerance test. Known validity of these markers using milk is limited, despite being common practice. Compositional variation, such as β-casein variants, in milk may impact diagnostic efficacy. This study aimed to evaluate the diagnostic accuracy to detect LNP using these commonly measured LM markers after both lactose and milk challenges.Methods: Fourty healthy young women were challenged with 50 g lactose then randomized for separate cross-over visits to ingest 750 mL milk (37.5 g lactose) as conventional (both A1 and A2 β-casein) and A1 β-casein-free (a2 Milk™) milk. Blood, breath and urine were collected prior to and up to 3 h following each challenge. The presence of C/T13910 and G/A22018 polymorphisms, determined by restriction fragment length polymorphism, was used as the diagnostic reference for LNP.Results: Genetic testing identified 14 out of 40 subjects as having LNP (C/C13910 and G/G22018). All three LM markers (breath H2, plasma glucose and urinary galactose/creatinine) discriminated between lactase persistence (LP) and LNP following lactose challenge with an area under the receiver operating characteristic (ROC) curve (AUC) of 1.00, 0.75 and 0.73, respectively. Plasma glucose and urinary galactose/creatinine were unreliable (AUC < 0.70) after milk ingestion. The specificity of breath H2 remained high (100%) when milk was used, but sensitivity was reduced with conventional (92.9%) and a2 Milk™ (78.6%) compared to lactose (sensitivities adjusted for lactose content). The breath H2 optimal cut-off value was lower with a2 Milk™ (13 ppm) than conventional milk (21 ppm). Using existing literature cut-off values the sensitivity and specificity of breath H2 was greater than plasma glucose to detect LNP following lactose challenge whereas values obtained for urinary galactose/creatinine were lower than the existing literature cut-offs.Conclusion: This study showed accurate diagnosis of LNP by breath H2 irrespective of the substrate used, although the diagnostic threshold may vary depending on the lactose substrate or the composition of the milk.Trial Registration: ACTRN12616001694404 . Registered prospectively on December 9, 2016. [ABSTRACT FROM AUTHOR]

Consumption of foods can be suppressed by two feeding system defense mechanisms: conditioned taste aversion (CTA) or taste avoidance learning (TAL). There is a debate in the literature about which form of intake suppression is caused by various aversive stimuli. For instance, illness-inducing stimuli like lithium chloride are the gold standard for producing CTA and external (or peripheral) painful stimuli, such as footshock, are the traditional model of TAL. The distinction between CTA and TAL, which have identical effects on intake, is based on differential effects on palatability. That is, CTA involves a decrease in both intake and palatability, whereas TAL suppresses intake without influencing palatability. We evaluated whether lactose, which causes gastrointestinal pain in adult rats, produces CTA or TAL. Using lick pattern analysis to simultaneously measure intake and palatability (i.e., lick cluster size and initial lick rate), we found that pairing saccharin with intragastric infusions of lactose suppressed both the intake and palatability of saccharin. These results support the conclusion that gastrointestinal pain produced by lactose malabsorption produces a CTA, not TAL as had previously been suggested. Furthermore, these findings encourage the view that the CTA mechanism is broadly tuned to defend against the ingestion of foods with aversive post-ingestive effects. [ABSTRACT FROM AUTHOR]

Background There are no studies on systemic sclerosis ( SSc) assessing the relationship between food intake, especially lactose, and gastrointestinal dysfunction. Aim To determine the prevalence of lactose malabsorption, using lactose breath test, in patients with SSc. To evaluate the correlation between lactose malabsorption and gastrointestinal involvement. To predict which SSc patients exhibit lactose malabsorption. Methods Seventy-seven consecutive Caucasian patients with SSc and 20 control subjects underwent lactose breath test. All patients also completed a questionnaire on digestive symptoms, and a global symptom score ( GSS) was calculated. Results The prevalence of lactose malabsorption was higher in SSc patients than in controls (44.3% vs. 10%; P = 0.004). We observed a marked correlation between the presence of lactose malabsorption and: higher values of GSS ( P < 0.0001); severe oesophageal ( P = 0.018) and small intestinal ( P = 0.04) motor disorders; and joint involvement ( P = 0.019). Furthermore, in SSc patients with symptomatic lactose malabsorption, the median value of GSS of digestive symptoms was lower after initiation of lactose-free diet ( P < 0.0001). Conclusions Our study underscores the fact that lactose malabsorption often occurs in patients with systemic sclerosis. Furthermore, our findings highlight the fact that lactose breath test is a helpful, noninvasive method, by identifying the group of patients with systemic sclerosis with symptomatic lactose malabsorption that may benefit from a reduction in lactose intake. [ABSTRACT FROM AUTHOR]

Background: The lactose breath test (LBT) is the standard technique for diagnosis of lactose malabsorption. However, it is time-consuming, strenuous for the patient and has been reported to have low sensitivity. The lactose intolerance quick test (LIQT) measures lactase activity in duodenal biopsies and may be performed as part of upper gastrointestinal endoscopy. Aim: The purpose of this study was to assess the role of the LBT and LIQT in the case management of suspected lactose malabsorption. Methods: The study group included 69 consecutive patients evaluated by the LBT followed by the LIQT. The test results were compared, and the sensitivity, specificity, and predictive values of the LBT were calculated. Results: Mean age of the patients was 54.4 years, male/female ratio was 1:3, and mean body mass index was 25.2. None had celiac disease on duodenal biopsy. The LIQT was positive for hypolactasia in 55 patients (80 %): mild in 14 (25 %) and severe in 41 (75 %); 10 (18 %) were symptomatic during the LBT. The LBT was positive for lactose malabsorption in 32 patients (46 %). Of the 37 patients with normal findings on the LBT, 24 (65 %) had positive findings on the LIQT: 11 (30 %) mild hypolactasia, 13 (35 %) severe hypolactasia. In one case, the LBT was positive and the LIQT was negative. The LBT had a sensitivity of 56 %, specificity 93 %, positive predictive value 97 %, and negative predictive value 35 %. Conclusions: The LBT may serve as a diagnostic screening tool for lactose malabsorption. Symptomatic patients with negative LBT results should be referred for second-line testing with the LIQT. [ABSTRACT FROM AUTHOR]

Objective. In a recent study by our group, it was shown that a large proportion of patients with lactose malabsorption and with no bacterial overgrowth are affected by silent coeliac disease (CD). Our aim was to evaluate the effect of a gluten-free diet on lactose malabsorption assessed using the hydrogen lactose breath test (LBT) and also the relationship with normalization of duodenal biopsies in coeliac patients. Material and methods. Fifteen patients (11 F, 4 M; mean age 35.8±6) affected by CD with a positive LBT and negative glucose breath test were enrolled. All were started on a gluten-free diet and were re-evaluated after 6 months by LBT and after 12 months by both LBT and upper gastrointestinal endoscopy with biopsies. Results. LBT normalization was observed in 1 out of 15 patients (6.7%) after 6 months and in 9 of the remaining 14 (64.2%) after 12 months. Duodenal biopsies showed normal villi in 8 patients, partial villous atrophy in 5 and total atrophy in 2. Conclusions. The present study shows that a large proportion of CD patients experience a regression of lactose malabsorption after receiving a gluten-free diet. This may be related to normalization of the brush border with an improvement of lactase enzyme activity. LBT should be performed after 12 months in CD patients on a gluten-free diet in order to assess the persistence/disappearance of lactose malabsorption, thus avoiding an unnecessary lactose-free diet. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of lactose malabsorption in young Lithuanian atopic dermatitis children; to evaluate the relationship between lactose malabsorption and the duration of exclusive breastfeeding, and the relationship between lactose malabsorption and cow's milk intolerance in parents and grandparents. Methods: 144 children with atopic dermatitis aged 1.5-24 mo (study group) and 32 children without symptoms of allergic diseases aged 1.5-23 mo (control group) were investigated. Lactose and glucose-galactose absorption tests based on serial blood glucose determination, culture of stool, latex agglutination test for rotavirus and microscopic examination of stool for parasites were performed. Results: Lactose malabsorption was determined in 59 (40.9%) and glucose-galactose malabsorption in 17 (11.8%) children with atopic dermatitis. The risk of developing lactose malabsorption was higher in children fed exclusively on breast milk up to 1 mo of age than in children fed exclusively on breast milk for 4 to 6 mo (OR: 2.62; 95% CI: 1.02-6.75). Lactose malabsorption was significantly more frequent in patients whose mothers did not tolerate cow's milk (20/30; 66.7%) than in patients whose mothers were tolerant to it (39/95; 41.1%) ( p = 0.02). Conclusion: Lactose malabsorption was determined in 40.9% of Lithuanian atopic dermatitis children aged under 2 y. Lactose malabsorption appeared to be associated with the duration of exclusive breastfeeding up to only 1 mo and mothers' milk intolerance. [ABSTRACT FROM AUTHOR]

Objective. To establish whether supplementation with a standard oral dose of Beta-Galactosidase affects hydrogen breath excretion in patients presenting with lactose malabsorption. Methods. Ninety-six consecutive patients positive to H2 Lactose Breath Test were enrolled. Mean peak H2 levels, the time to reach the peak H2, the time to reach the cut-off value of 20 ppm, the cumulative breath H2 excretion, the areas under the curve, and a Visual Analogical 10-point Scale for symptoms were calculated. Genotyping of the C/T-13910 variant was carried out. Results. Following the oral administration of Beta-Galactosidase, in 21.88% of the cases, H2 Lactose Breath Test became negative (Group A), while mean peak H2 levels (74.95 ppm versus 7.85),p < 0.0000, in 17.71% (Group B) were still positive, with the H2 level 20 ppm above the baseline, but the peak H2 levels were significantly lower than those observed at the baseline test (186.7 ppmversus 66.64), p < 0.0000, while in 60.41% (Group C) they were still positive with the peak H2 levels similar to those observed at the baseline test (94.43 versus 81.60 ppm). All 96 individuals tested presented the C/C-13910 genotype nonpersistence. Conclusions. The response to oral administration of Beta-Galactosidase in patients with symptoms of lactose malabsorption presents a significant variability. [ABSTRACT FROM AUTHOR]

The aim of this study was to establish a retrospective evaluation and comparison of the hydrogen/methane (H2/CH4) breath test and genetic test (C/T-13910 polymorphism) results in lactose malabsorption testing. In total 263 consecutive patients with suspected lactose malabsorption were included in this study. They underwent the H2/CH4 breath test following the ingestion of 50 g lactose and were tested for the C/T-13910 polymorphism. In total 51 patients (19.4%) had a C/C-13910 genotype, indicating primary lactose malabsorption. Only 19 patients (7.2%) also had a positive H2/CH4 breath test. All in all 136 patients (51.69%) had a C/T-13910 and 76 patients (28.91%) a T/T-13910 genotype, indicating lactase persistence. Four patients (1.5%) with the C/T-13910 genotype and one patient (0.4%) with the T/T-13910 genotype had a positive H2/CH4 breath test result, indicating secondary lactose malabsorption. Cohen's Kappa measuring agreement between the two methods was 0.44. Twenty patients (7.6%) with a positive H2/CH4 peak within 60 minutes after lactose ingestion were classified as patients with lactose-dependent small intestinal bacterial overgrowth (SIBO). In conclusion, only moderate agreement between the breath test and the genetic test was shown. Secondary lactose malabsorption as well as preanalytical limitations of the combined H2/CH4 breath test procedure can cause discrepant results. This trial is registered with K-42-13. [ABSTRACT FROM AUTHOR]

Objective. The prevalence of lactose malabsorption (LM) is increased in the elderly, although the mechanisms responsible are still a matter of speculation. The objective of this study was to investigate the possible roles of reduced functional small intestinal absorptive area, lactase deficiency and small intestinal bacterial overgrowth (SIBO). Material and methods. Twenty Caucasian (Anglo-Celtic), asymptomatic, well-nourished, elderly volunteers (median age 79 years, range 70-94 years) with no clinically apparent predisposition to SIBO underwent a 50 g lactose breath hydrogen test (LBHT) and mannitol absorption test, the latter as an index of functional small intestinal absorptive area. Those with LM additionally underwent bacteriological assessment of small intestinal secretions and mucosal biopsy, to assess the contribution of SIBO and lactase deficiency, respectively, to the pathogenesis of LM in individual cases. The prevalence of SIBO was also determined in elderly subjects without LM. Twenty asymptomatic younger subjects (median age 29 years, age range 18-35 years) served as controls. All subjects were "hydrogen producers" in response to lactulose. Results. LM was evident in 10/20 (50%) elderly subjects and 1/20 (5%) younger subjects (p=0.003). Mannitol absorption did not differ significantly in elderly and younger subjects or in elderly subjects with and without LM. SIBO was documented in 9/10 (90%) elderly subjects with LM; eradication was associated with resolution of LM. Lactase deficiency was evident in only one elderly subject with LM. SIBO was evident in 2/10 (20%) elderly subjects without LM (p=0.005 compared to those with LM). Lactulose breath hydrogen test identified only 2/11 (18%) elderly subjects with SIBO. Conclusions. Increased prevalence of LM in the elderly is mostly due to clinically non-apparent SIBO, rather than mucosal factors. The lactulose breath hydrogen test cannot be relied upon to identify elderly subjects with SIBO, even in those without an anatomical predisposition. [ABSTRACT FROM AUTHOR]

Lactose malabsorption is not always associated with intolerance symptoms. The factors responsible for symptom onset are not yet completely known. As differences in visceral sensitivity may play a role in the pathogenesis of functional symptoms, we evaluated whether an alteration of visceral sensitivity is present in subjects with lactose intolerance. Thirty subjects, recruited regardless of whether they were aware of their capacity to absorb lactose, underwent an evaluation of intestinal hydrogen production capacity by lactulose breath test, followed by an evaluation of lactose absorption by hydrogen breath test after lactose administration and subsequently an evaluation of recto-sigmoid sensitivity threshold during fasting and after lactulose administration, to ascertain whether fermentation modifies intestinal sensitivity. The role of differences in gastrointestinal transit was excluded by gastric emptying and mouth-to-caecum transit time by 13C-octanoic and lactulose breath tests. Lactulose administration induced a significant reduction of discomfort threshold in subjects with lactose intolerance but not in malabsorbers without intolerance symptoms or in subjects with normal lactose absorption. Perception threshold showed no changes after lactulose administration. Severity of symptoms in intolerant subjects was significantly correlated with the reduction of discomfort thresholds. Visceral hypersensitivity should be considered in the induction of intolerance symptoms in subjects with lactose malabsorption. [ABSTRACT FROM AUTHOR]

Background: Lactase activity declines with age in rats, but it is not clear whether this model is also shared by humans. Few studies have evaluated lactose intolerance and malabsorption in the elderly and no definite conclusions can be drawn. The aim of our study was therefore to verify the impact of age on lactose intolerance and malabsorption. Methods: Eighty-four healthy subjects took part in the study. Thirty-three were < 65 years, 17 were between 65 and 74 years and 34 were > 74 years. All the subjects underwent a preliminary evaluation of intestinal gas production capacity and oro-cecal transit time by H[sub 2]/CH[sub 4] breath test after lactulose. After a 3-day period, an H[sub 2]/CH[sub 4] breath test after lactose was performed. The occurrence of intolerance symptoms during the test and in the 24 h after the test was recorded. Results: Breath H[sub 2] and CH[sub 4] excretion parameters at fasting and after lactulose did not differ between the three groups. Cumulative breath H[sub 2] excretion after lactose was higher in subjects > 74 years than in subjects < 65 years and in subjects aged 65-74 years, while no difference was found between the latter two groups. In subjects > 74 years, the prevalence of lactose malabsorption was higher than in the other two groups, while no significant difference was observed between subjects < 65 years and subjects aged 65-74 years. Within the malabsorber subjects, the prevalence of lactose intolerance was higher in subjects < 65 years than in those aged 65-74 years and in those aged > 74 years. No significant difference was found between the latter two groups. No difference was found between the three groups in terms of daily calcium intake and a significant negative correlation between symptom score and daily calcium intake was only found in the group of subjects aged < 65 years. Conclusions: As age increases, the prevalence of lactose malabsorption shows an increase while the prevalence of intolerance symptoms among malabsorbers shows a decrease. Accordingly, daily calcium intake was similar among the adults and elderly studied. [ABSTRACT FROM AUTHOR]

Background Lactose malabsorption ( LM), diagnosed currently using lactose hydrogen breath and tolerance tests ( LHBT, LTT) with a high, nonphysiological dose (50-g), may mimic irritable bowel syndrome ( IBS). In LM-endemic areas, clinically significant malabsorption (lactose intolerance) may be better diagnosed using a lesser dose, and positive results so obtained may predict response to milk withdrawal more effectively. Methods Fifty patients each with IBS (Rome III) were evaluated using LHBT and LTT with 50-g, 25-g, and 12-g lactose. Sensitivity and specificity of LHBT and LTT with different dosages (gold standard: lactase gene C/ T-13910 polymorphism) and symptom development were evaluated. Effect of milk withdrawal was studied. Result Of 150 patients, 37/50 (74%) and 28/50 (56%) had LM by LHBT and LTT using 50-g lactose; 41/50 (82%) and 31/50 (62%) had LM using 25-g lactose, and 14/50 (28%) and 29/50 (58%) using 12-g lactose, respectively. Sensitivity and specificity of LHBT using 50-g, 25-g, and 12-g lactose were 92.6%, 52.0%, and 94%, 60%, and 36.4%, 88.2%, and those of LTT, 92%, 80.0%, and 84.8%, 82.4%, and 66.7%, 58.8%, respectively. Breath hydrogen correlated with lactose dose. Though patients developing symptoms with 50-g lactose exhaled more hydrogen than those remaining asymptomatic, hydrogen levels did not differ following 25-g and 12-g dosages in relation to symptom development. Patients' milk intake was 335 ± 92 mL/d (≈ 16.7 ± 9.6-g lactose). Positive LHBT using 25-g dose better predicted symptom resolution than by 50-g and 12-g lactose. Conclusion Twenty-five gram is the ideal dose of lactose for LHBT and LTT in LM-endemic areas. [ABSTRACT FROM AUTHOR]

Background and Aims: To compare the prevalence of lactose malabsorption (LM) in children by analyzing hydrogen content in expired air vs. the inclusion of methane excretion. Methods: A total of 138 children (4–17 years old) attending different boarding schools in Mexico were included in this study. To measure H2 and CH4 in expired air, breath samples were collected before administering whole milk (240 mL for 4- to 6-year-old children and 360 mL for 7- to 17-year-old children) and at 60, 120, 180, and 240 min afterward. A coprological examination was also carried out. Results: Methane production prevalence was 47.8% (29.7% of the children produced methane and hydrogen, whereas 18.1% produced methane only). When measuring only exhaled hydrogen in expired air (H2 ≥20 ppm), prevalence of LM was 31%; however, when methane concentration was considered (H2 + (CH4 x 2)) ≥18 ppm, prevalence increased significantly to 44%. Among children with LM, 51.6% presented intestinal parasites. Conclusions: Methane should be measured in exhaled air to improve diagnosis of LM in populations with a high prevalence of methane production. [Copyright &y& Elsevier]

Background Fructose malabsorption, lactose malabsorption and an early rise in breath hydrogen after lactulose (ERBHAL) may play roles in induction of symptoms in gastrointestinal conditions. Aim To compare prevalence and interactions of fructose malabsorption, lactose malabsorption and ERBHAL among healthy subjects and those with chronic intestinal disorders using consistent breath hydrogen testing methodologies. Methods Consecutive series of Caucasian patients with Crohn’s disease ( n = 91), ulcerative colitis (56), functional gastrointestinal disorders (FGID) (201), coeliac disease (136) and 71 healthy volunteers underwent breath hydrogen testing using lactulose, fructose and lactose. Results Early rise in breath hydrogen after lactulose occurred more commonly in healthy controls (39%) than in Crohn’s disease (20%) and untreated coeliac disease (14%; P < 0.008), but not FGID (27%), ulcerative colitis (26%) or treated coeliac disease (29%). Fructose malabsorption was more frequent in Crohn’s disease (61%) than other groups (33–44%, P < 0.05). Lactose malabsorption was most common in Crohn’s disease (42%) and ulcerative colitis (40%) and uncommon (10%) in 79 patients with newly diagnosed coeliac disease. In Crohn’s disease, concurrent Fructose malabsorption and lactose malabsorption was most common (29%), and the association of fructose malabsorption with ERBHAL seen overall (62%) was not observed (36%, P < 0.0001). Conclusions Carbohydrate malabsorption and ERBHAL are normal physiological phenomena. The abnormal patterns observed in Crohn’s disease may have pathogenic importance. [ABSTRACT FROM AUTHOR]

As decreased bone mineral density (BMD) is a common problem in cystic fibrosis (CF) and milk products may have pivotal dietary role affecting BMD, we aimed to assess the potential influence of adult-type hypolactasia (ATH) and lactose malabsorption (LM) on BMD in adolescent and young adult patients. In 95 CF pancreatic-insufficient patients aged 10-25 years (without liver cirrhosis, steatosis and cholestasis, diabetes mellitus, systemic glucocorticoid therapy), lumbar BMD, the nutritional status, pulmonary function, vitamin D3 concentration, calcium intake and single-nucleotide polymorphism upstream of the lactase gene were assessed. In subjects with the −13910 C/C genotype predisposing to ATH, the presence of LM was determined with the use of a hydrogen-methane breath test (BT). BMD and calcium intake were significantly lower in patients with the C/C genotype (P<0.028 and P<0.043, respectively). The abnormal BMD was stated more frequently in patients with the C/C genotype (P<0.042) and with LM (P<0.007). BMD, daily calcium intake and serum vitamin D concentration were significantly lower in LM subjects than in the other patients (P<0.037, P<0.000004 and P<0.0038, respectively). In logistic regression analysis, the relationship between examined parameters and BMD, was found to be statistically significant (P<0.001). However, only standardized body weight and LM were documented to influence BMD (P<0.025 and P<0.044, respectively). In conclusion, LM seems to be an independent risk factor for decreased BMD in CF patients. [ABSTRACT FROM AUTHOR]

Background: When lactose malabsorption gives rise to symptoms, the result is called ‘lactose intolerance’. Although lactose intolerance is often bothersome for patients, once recognized it may be managed by simple dietary adjustments. However, diagnosing lactose intolerance is not straightforward, especially in primary care. [ABSTRACT FROM PUBLISHER]

Background: Symptoms after intake of milk are common in persons with irritable bowel syndrome (IBS). The aims of this study were to compare the prevalence of lactose malabsorption (LM) and symptoms related to intake of milk and lactose in subjects with IBS with that of healthy volunteers, and to search for symptoms that are characteristic of LM. Methods: A case-control study in a Norwegian population was initiated. Subjects with IBS were asked for symptoms related to intake of milk and lactose, tested for LM, and compared with a group of healthy volunteers. Results: The study comprised a total of 187 persons (82 with IBS and 105 volunteers), females/males: 138/49, mean age 47 years. In subjects with IBS and in healthy volunteers, LM was present in 3/74 (4.1%) and 4/105 (3.8%), respectively (ns), milk-related symptoms in 32/79 (40%) and 13/105 (12%), respectively ( P < 0.001) and symptoms after intake of lactose in 28/74 (38%) and 21/104 (20%), respectively ( P = 0.01). Borborygmi starting within 5 h after intake of lactose and lasting for more than 2 h indicated LM (OR 61 (95% CI:­8-475), P < 0.001). Conclusions: IBS and LM are unrelated disorders in a Norwegian population. Milk-related symptoms and symptoms after intake of lactose are unreliable predictors for LM. Precise symptom-based criteria might enhance the diagnostic accuracy for LM. [ABSTRACT FROM AUTHOR]

Deals with a study which compared the different indirect diagnostic methods for lactose malabsorption. Methods used in the study; Results and discussion.

Résumé: Le lactose, principal sucre du lait, est un disaccharide dont l’absorption au niveau de l’intestin grêle est dépendante de son hydrolyse en glucose et galactose par la lactase, enzyme présente au niveau de la bordure en brosse des entérocytes. En cas de déficit de cette enzyme, le lactose non hydrolysé est métabolisé par la flore bactérienne anaérobie du côlon. Les métabolites générés, acides gras à courte chaîne, hydrogène, dioxyde de carbone et méthane, sont retenus responsables des symptômes tels que douleur abdominale, météorisme, flatulence, diarrhée. Le déficit en lactase peut être d’origine congénitale, d’origine primaire acquise ou d’origine acquise secondaire à des pathologies lésant la muqueuse intestinale. La malabsorption du lactose est la conséquence de l’hypolactasie dont l’expression clinique est l’intolérance au lactose : dans la pratique clinique courante, la malabsorption est diagnostiquée grâce au test respiratoire à l’hydrogène après ingestion de lactose, qui doit être couplé au recueil des symptômes d’intolérance éventuellement provoqués par ce test. Le traitement repose sur l’exclusion ou la réduction du lactose de l’alimentation, traitement qui doit être réservé aux sujets symptomatiques (ű intolérants Ƈ). Un suivi diététique est souhaitable afin de ne pas méconnaître d’éventuelles carences nutritionnelles, notamment calcique. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To evaluate the efficacy of the addition to milk, 5?min and 10?h before its consumption, of a lactase obtained from Kluyveromyces lactis in lactose malabsorbers with intolerance. DESIGN:: Double-blind, placebo-controlled, crossover study. SETTING:: University Hospital. SUBJECTS:: In total, 11 male and 19 female (aged from 18 to 65?y, mean age 43.3?y) lactose malabsorbers with intolerance participated. INTERVENTIONS:: Each patient underwent three H2 breath tests, in a random order. We used 400?ml of cow's semiskimmed milk as substrate and aß-galactosidase obtained from K. lactis. The test A was carried out adding to the milk the enzyme (3000?UI), 10?h before its consumption; the test B was performed adding theß-galactosidase (6000?UI) 5?min before milk ingestion and the test C was made using placebo. We evaluated the maximum breath H2 concentration, the cumulative H2 excretion and a clinical score based on intolerance symptoms (bloating, abdominal pain, flatulence and diarrhoea). RESULTS:: Our study showed a significant reduction of the mean maximum H2 concentration after both test A (12.07±7.8?p.p.m.) and test B (13.97±7.99?p.p.m.) compared with test C (51.46±16.12?p.p.m.) (ANOVA F=54.33, P<0.001). Similarly, there was a significant reduction of the mean cumulative H2 excretion after both test A (1428±1156?p.p.m.) and test B (1761±966?p.p.m.) compared with test C (5795±2707?p.p.m.) (ANOVA F=31.46, P<0.001). We also observed a significant reduction of the mean clinical score after both test A (0.36±0.55) and test B (0.96±0.85) compared with test C (3.7±0.79) (ANOVA F=106.81, P<0.001). Moreover, with regard to the mean clinical score, there was a significant reduction after test A with respect to test B (Bonferroni's P=0.03). CONCLUSIONS:: Our study shows that in lactose malabsorbers with intolerance, the lactase obtained from K. lactis can represent a valid therapeutic strategy, with objective and subjective efficacy and without side effects.European Journal of Clinical Nutrition (2005) 59, 489-493. doi:10.1038/sj.ejcn.1602098 Published online 26 January 2005 [ABSTRACT FROM AUTHOR]

One hundred seventy-two normal Thai infants and children were studied to determine the prevalence of lactose malabsorption and lactase deficiency. These abnormalities became manifest after infancy, and by age 2 years virtually all children studied were abnormal. Sucrase and maltase activities and sucrose and glucose absorption were normal in most. Calculation of ratios of median maltase/lactase, sucrase/lactase, and maltase/sucrase activities also indicated the major abnormality to be isolated lactase deficiency. Lactose malabsorption appeared earlier in life in a group of normal institution Thai children compared to a group of village children. This suggests that environmental factors may be important in the pathogenesis of lactase deficiency in Thai children, although genetic influences cannot be excluded. [ABSTRACT FROM AUTHOR]

Presents information on a study which identified the effects of advancing age on lactose malabsorption in women and determined whether lactose malabsorbers have lower bone mineral density or display faster bone loss than lactose absorbers. Background to the study; Methods; Results; Conclusions.

Background and Aim Lactase non-persistence is common in India. We evaluated: (i) frequency of lactase gene ( C/ T-13910 and G/ A-22018) polymorphisms in irritable bowel syndrome ( IBS) and healthy controls ( HC), (ii) association between these polymorphisms and IBS-subtypes and symptoms. Methods A total of 150 IBS patients ( Rome- III criteria) and 252 age and gender-matched HC were evaluated for C/ T-13910 and G/ A-22018 genotypes using polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP). Results Totals of 79 (52%), 52 (35%) and 19 (13%) patients had diarrhea-predominant IBS ( D- IBS), constipation predominant IBS ( C- IBS) and alternating diarrhea and constipation IBS ( A- IBS), respectively ( Rome- III). Frequency of C/ T-13910 [genotypes: CC 102 (68%), CT 43 (29%), TT 5 (3%) vs CC 155 (61%), CT 83 (33%), TT 14 (6%), P > 0.05] and G/ A-22018 [ GG 97 (65%), GA 41 (27%), AA 12 (8%) vs GG 154 (61%), GA 78 (31%), AA 20 (8%), P > 0.05] were similar among IBS and HC. Patients with D- IBS more often had C/ T-13910 and G/ A-22018 genotypes than C- IBS ( CC 71 [90%], CT 6 [8%], TT 2 [2%]) versus (24 [46%], 25 [48%], 3 [6%]), A- IBS (7 [39%], 12 [63%], 0, [0%]) and HC (155 [61%], 83 [33%], 14 [6%]), P < 0.0001 and ( GG 69 [87%], GA 6 [8%], AA 4 [5%]) vs (22 [42%], 24 [46%], 6 [12%]) vs (6 [32%], 11 [58%], 2 [10%]), P < 0.0001. IBS with CC and GG genotypes more often had abdominal pain ( P = 0.005), distension ( P = 0.031) and higher stool frequency ( P = 0.003) and reported symptoms following dairy products than non- CC ( P < 0.0001). Conclusion Though C/ T-13910 and G/ A-22018 polymorphisms were comparable among IBS and HC, these were more common among D- IBS and reported some symptoms like abdominal pain, bloating and exacerbation by dairy products. [ABSTRACT FROM AUTHOR]

OBJECTIVES: An increased prevalence of lactose intolerance is seen in irritable bowel syndrome (TB 5). Recently, we demonstrated a high prevalence of abnormal lactulose breath test results in lBS suggesting bacterial overgrowth. Because symptoms of lactose intolerance result from bacterial fermentation, the purpose of this study was to determine whether an abnormal lactose breath test is reflective of malabsorption or early presentation to bacteria. METHODS: Subjects with diarrhea-predominant lBS were enrolled. On day 1, subjects underwent a lactulose breath test after an overnight fast. Within 1 wk, subjects returned after fasting for a lactose breath test with simultaneous blood glucose measurements every 15 mm to complete a lactose tolerance test (LTT). Symptoms were evaluated 3 h after lactose administration. RESULTS: Twenty subjects completed the study. One subject inadvertently received dextrose through the intravenous and was excluded. Of the remaining 19 subjects, three (16%) had an abnormal LTT suggesting malabsorption. In all, 10 subjects (53%) had an abnormal lactose breath test, 14 (74%) had an abnormal lactulose breath test, and 11(58%) had symptoms after lactose administration. The agreement with symptoms was moderate (κ = 0.47) and fair (κ = 0.24) when compared to the lactose breath test and LTT, respectively. There was a fair correlation between lactose breath test and LTT (κ = 0.29). However, lactose breath test hydrogen levels >166 ppm were universally predictive of abnormal LTT. Finally, a significant correlation was seen between the hydrogen production on lactose and lactulose breath test (r = 0.56, p = 0.01). CONCLUSIONS: Lactose breath testing in lBS subjects does not seem to reflect malabsorption; it may be an indicator of abnormal lactulose breath test, suggesting bacterial overgrowth. [ABSTRACT FROM AUTHOR]

Examines the lactose malabsorption in Polynesian and white children by breath hydrogen technique in Oceania. Influence of environment on lactose malabsorption; Prevalence of malabsorption in different locations; Effect of lactose malabsorption on acceptance and consumption of milk in both races.

Investigates the effects of skim milk, whole milk, whole milk with cornflakes, chocolate milk, skim milk with added sucrose and lactic cultures on lactose intolerance. Improved tolerance to lactose when ingested as chocolate milk; Effects of milk containing Lactobacillus acidophilus and Bifidobacterium organisms; Influence on the rate of gastric emptying.

Roux-en-Y gastric bypass (RYGB) can cause multiple food intolerances and gastrointestinal complaints are frequently reported after dairy consumption. We aimed to determine the prevalence of lactose malabsorption and intolerance, and complaints associated with dairy consumption in daily life, before and after RYGB. The lactose breath test (LBT) and lactose tolerance test (LTT) was performed in 84 patients awaiting RYGB surgery and 84 patients after surgery. Gastrointestinal symptoms at baseline and after testing were recorded. Lactose malabsorption was defined as a positive LBT and/or LTT. Lactose intolerance as a positive test combined with an increase of gastrointestinal complains. Dairy consumption in daily life and successive gastrointestinal complaints were registered via a questionnaire. Results of preoperative and postoperative patients were compared. Lactose malabsorption was present in 15 (17.9%) of the preoperative patients and in 25 (29.8%) of the postoperative patients (OR 2.46; 95%CI: 1.08–5.59; p =.03). Of the preoperative patients 6 (7.1%) patients met the criteria for lactose intolerance, compared to 8 (9.5%) patients in the postoperative group (OR 1.48; 95%CI 0.48–4.57; p =.50). Twelve (14.3%) preoperative patients indicated to have gastrointestinal complaints after dairy consumption in daily life versus 45 (53.6%) postoperative patients (p <.01). This study shows no increase in patients with proven lactose intolerance after RYGB compared to preoperative patients. Gastrointestinal complaints after dairy consumption in daily life were far more frequently reported by RYGB patients. It is unlikely that all reported gastrointestinal complaints are actually caused by lactose. Other ingredients in dairy, like fat, are possibly contributory. [ABSTRACT FROM AUTHOR]

Unlabelled: Lactase deficiency has a high prevalence worldwide. Thus, a valid symptom scale would be a useful tool for identifying patients with lactose malabsorption.Objective: To develop, validate, and apply a symptoms questionnaire on lactose malabsorption to identify lactose malabsorbers diagnosed with the gold-standard hydrogen breath test.Methods: In the first part of the study, 292 patients completed a questionnaire at the end of a 50-g lactose breath test. The questionnaire included five items (diarrhea, abdominal cramping, vomiting, audible bowel sounds, and flatulence or gas) scored on a 10-cm visual analogue scale. In the second part of the study, 171 patients completed the questionnaire twice: first, according to their opinion when consuming dairy products at home and second, after a 50-g lactose breath test. Patients were grouped as absorbers or malabsorbers according to the result of the breath test.Results: Diarrhea, abdominal cramping, and flatulence were scored significantly higher in malabsorbers than in absorbers. Total score of the symptomatic questionnaire was significantly higher in malabsorbers (17.5 versus 3.0, P<0.01). According to receiver operator characteristics (ROC) analysis, the most discriminant cut-off of the total score to identify lactose malabsorption was 6.5 (sensitivity 0.75, specificity 0.67). In 58 malabsorbers the effect size of the questionnaire to determine sensitivity to change was 1.32. In the second part of the study, scoring of the home questionnaire was higher than after the lactose-breath test. The lactose malabsorbers rate was higher according to the home questionnaire than after the lactose breath test (72% versus 52%). The home questionnaire had excellent sensitivity (0.82) but low specificity (0.35).Conclusion: We developed and validated a five-item symptoms questionnaire for lactose malabsorption. This is a valid test that permits patients with a total score lower than 7 to be excluded from future studies. [ABSTRACT FROM AUTHOR]

Lactose malabsorption (LM; adult-type hypolactasia), an autosomal recessive condition, results from the down-regulation of the activity of lactase enzyme in the intestinal wall. In previous studies the effect of LM on bone mass, bone turnover rate, development of osteoporosis and osteoporotic fractures has remained controversial. We have recently identified a single nucleotide polymorphism (SNP), a C to T change residing 13910 base pairs upstream of the lactase (LCT) gene at chromosome 2q21-22, which shows complete association with lactase persistence, with the C/C-13910 genotype defining LM and the genotypes C/T-13910 and T/T-13910 lactase persistence. The present study was undertaken to examine the relationship of the C/T-13910 polymorphism to peak bone mass, bone turnover rate, and stress fractures among young Finnish men. The study population comprised 234 young men, aged 18.3 to 20.6 years, 184 men were recruits of the Finnish Army, and 50 were men of similar age who had postponed their military service for reasons not related to health. Bone mineral content (BMC), density (BMD), and scan area were measured in the lumbar spine and upper femur by dual-energy X-ray absorptiometry (DXA). Blood was sampled for genotyping of the C/T-13910 polymorphism and determination of serum 25-hydroxyvitamin D (25OHD), intact parathyroid hormone (iPTH), type I procollagen aminoterminal propeptide (PINP), and tartrate-resistant acid phosphatase 5b (TRACP5b). Second-void urine samples were collected for the determination of type I collagen aminoterminal telopeptide (NTX). The prevalence of the C/C-13910-genotype of these young adults did not differ significantly from the corresponding population prevalence of C/C-13910 (17.1% vs 18.1%) among Finnish blood donors. Fifteen recruits of the army experienced a stress fracture; 3 of them (20%) had the C/C-13910-genotype. Calcium intake was similar for the three genotypes as were the unadjusted BMCs, scan areas, and BMDs at different measurement sites. The adjustments for age, height, weight, smoking, alcohol consumption, and physical exercise in the multiple regression analysis did not reveal any significant relationships between the lactase genotypes and BMDs at lumbar (P= 0.16), femoral neck (P= 0.99) or total hip (P= 0.96) sites. Serum 25OHD, iPTH, and bone marker levels were similar for the C/C-13910 C/T-13910 and T/T-13910 genotypes. In summary, in young Finnish men, molecularly defined lactose malabsorption does not alter bone turnover rate and impair the acquisition of peak bone mass. Moreover, the C/C-13910 genotype does not seem to be a risk factor for stress fractures in army recruits. [ABSTRACT FROM AUTHOR]

Examines the incidence of lactose malabsorption in adults. Types of lactose deficiency; Symptoms of malabsorption; Treatment for malabsorption.

A review is presented of the article "Systematic Review: Effective Management Strategies for Lactose Intolerance" by A. Shaukat et al., which appeared in a 2010 issue of the "Annals of Internal Medicine".

Background: Limited data suggest a high prevalence of lactose maiabsorption (LM) in the elderly. The mechanism is uncertain. A significant increase in enterocyte apoptosis raises the possibility that a subtle reduction in mucosal absorptive area, undetectable by standard structural analyses may be responsible especially if compensatory enterocyte prolireration is inadequate. Assessment of intestinal absorption of mannitol, taken up transcellularly and hence an index of absorptive area, and intestinal permeability, reflected by urinary lactulose/ mannitol ratios, may resolve this issue. Methods: We studied 20 asymptomatic elderly subjects (median age 76, range 65-94 years) and 20 controls (median age 29, range 21-35 years) with no history of gastrointestinal disease or use of drugs that disturb gut permeability. All were hydrogen producers following ingestion of lactulose. A 50 g lactose breath hydrogen test was performed after dietary preparation and an 8 hour fast. Breath hydrogen was measured by gas chromatography. Lactulose/mannitol ratios were measured by gas-liquid chromatography in urine collected over 6 hours after ingestion of 10 g lactulose and 5 g mannitoh Urinary creatinine levels were measured so that differences in renal function did not confound interpretation of urinary mannitol levels. Results: LM, defined by a rise n breath hydrogen > 20 ppm above baseline, was present in 10/20 (50%) elderly subjects and 0/20 controis. Urinary mannitol/creatinine ratios did not differ significantly in elderly and control subjects (median 111.1, range 17.6-149 v median 92.8, range 45.9-140.8; p = 0.62) or in elderly subjects with and without LM (median 111.1, range 35.6-149 v median 106.7, range 17.6-138; p = 1.0). Urinary lactulose/mannitol ratios were significantly increased in the elderly (medan 0.018, range 0.007-0.063) compared to controls (median 0.011, range 0.0070.025; p = 0.003), but did not differ significantly in elderly subjects with and without LM... [ABSTRACT FROM AUTHOR]

For many years, different studies have been conducted on the treatment or reducing the harmful effects of lactase deficiency, which is prevailing all around the world. Lactase deficiency, which causes to reduce milk consumption, is mainly based on genetic factors, and they inhibit the prevention of this disease. However, even if it cannot be prevented, it is possible to control the disorders that occur to allow milk consumption. Therefore, alternative methods are being sought to reduce these effects. Recent studies have shown that probiotics and prebiotic consumption reduces the impacts of lactase deficiency in people with lactose intolerance. This paper reviews the studies on the effects of probiotic and prebiotic use on lactose intolerance. [ABSTRACT FROM AUTHOR]

Background: Lactose intolerance is defined as "Lactose malabsorption with gastrointestinal symptoms." Also, lactose malabsorption can be defined as "Not all ingested lactose was absorbed and that some has reached the large intestine." The common symptoms associated with the maldigestion of lactose are bloating, diarrhoea, nausea, and abdominal pain. Aim: The current study aims to assess knowledge of people awareness of the lactose intolerance disorder and its relation to nutrition and dietary habits in Saudi Arabia. Methods: A descriptive cross-sectional approach was used targeting all accessible population in Saudi Arabia aging 18 years or more and accept to participate in the study. Data were collected from participants using an online pre-structured questionnaire. The researchers constructed the survey tool after intensive literature review and expert's consultation. The questionnaire covered the following data: participants' socio-demographic data like age, gender, and monthly income. Second section covered participants' dairy products intake with associated symptoms. Third part covered personal and family history of glucose intolerance disorder among the study participants. Awareness was assessed using multiple repose and mutually exclusive questions. Results: A total of 1189 participants fulfilling the inclusion criteria completed the study questionnaire. Participants ages ranged from 18 to 58 years old with mean age of 25.1 ± 12.9 years. Exact of 692 (58.2%) participants were females. Exact of 104 (8.7%) of the study participants reported that they had lactose intolerance disorder which started at the age of 11 to 20 years among 41 (39.4%) and at the age of 21 to 30 years among 36 (34.6%). About 77% of the study participants know that lactose indolence disorder symptoms appear after eating dairy or its derivatives. A total of 45.8% reported that leaky gut syndrome (diarrhoea and bloating) is caused by symptoms that occur with lactose intolerance and 39.4% know lactose intolerance is an uncurable disease. Conclusion: In conclusion, this study revealed that nearly one out of each three persons on Saudi Arabia is knowledgeable regarding lactose intolerance disorder and its related factors and relieving factors. Dairy products use in daily basis was reported among two thirds of the study population with abdominal distention and abdominal pain was the main accompanying symptoms. [ABSTRACT FROM AUTHOR]

This case report examines the impact of a single session of functional neurology on a 35-year-old female patient diagnosed with lactose intolerance. The patient presented with severe gastrointestinal symptoms, including frequent diarrhea, bloating, and vomiting upon dairy consumption. The intervention aimed to reset dysfunctional neurological programs believed to contribute to her condition. The study utilized a standardized lactose intolerance breath test to measure the hydrogen and methane levels at various intervals before and after treatment. Post-treatment results showed symptomatic relief with the patient reporting normalized bowel movements and the absence of previous symptoms. Despite these improvements, the biochemical markers at higher time points (150 and 175 min) post-treatment remained similar to the pre-treatment values, indicating persistent lactose malabsorption and highlighting the variability of hydrogen measurements. This case report suggests that a single session of functional neurology can significantly alleviate the symptoms of lactose intolerance. However, the preliminary nature of these results underscores the need for further research involving larger sample sizes and long-term follow-up to fully understand the treatment's efficacy and underlying mechanisms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lactose malabsorption (LM) is a very common problem with high prevalence in Southern Europe. The lactose tolerance test (LTT) is a basic probe, which is widespread in local hospitals, because it requires non-complex and inexpensive infrastructure. The aims of our study are to determine that a reduction in the duration of LTT does not affect its diagnostic accuracy to detect LM and to calculate the savings that this reduction may represent. METHODS: A prospective study of consecutive patients who underwent LTT for suspected LM was conducted. We analyzed and compared the clinical results and costs (extraction, analytical measurement, time spent by nursing staff, technicians and patients) of suppressing LTT points at 30 and 120 min. RESULTS: The study included 201 patients. Pathological LTT was found in 119 cases. Eliminating the measurement of glucose at 120 min did not alter the LTT interpretation in any patient; however, up to 18.4% of patients had a LTT misinterpretation when the 30 min point was suppressed. If the LTT 120 min measurement would have been suppressed, 41 334 euros could have been saved. CONCLUSIONS: Suppressing the 120 min LTT point does not imply any changes in clinical results and reduces patient’s waiting time; it also benefits the health system by saving time, manpower and materials. [ABSTRACT FROM AUTHOR]

This article discusses the future of testing for lactose intolerance. It explains that symptoms such as bloating, flatulence, and abdominal pain may indicate carbohydrate malabsorption, which affects around 30% of people in Western nations. The article explores the use of breath testing as a non-invasive and safe diagnostic tool for detecting carbohydrate malabsorption. It also discusses the limitations of breath testing and the importance of accurately identifying lactose intolerance rather than just lactose malabsorption. The article suggests that future research should focus on identifying and treating specific carbohydrate intolerances in disorders such as irritable bowel syndrome. [Extracted from the article]

Presents a letter to the editor of the "Scandinavian Journal of Gastroenterology," about a studt of lactose malabsorption and functional gastrointestinal disorders.