1. Role of the gut microbiome in mediating lactose intolerance symptoms
- Author
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Johanne E. Spreckels, Cisca Wijmenga, Arnau Vich Vila, M.F. Brandao Gois, Trishla Sinha, Alexander Kurilshikov, Jingyuan Fu, Laura A Bolte, Rinse K. Weersma, Alexandra Zhernakova, Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Center for Liver, Digestive and Metabolic Diseases (CLDM), and Translational Immunology Groningen (TRIGR)
- Subjects
0301 basic medicine ,Malabsorption ,bacterial interactions ,Lactose metabolism ,malabsorption ,medicine.medical_treatment ,lactase ,bifidobacteria ,Biology ,digestive system ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Lactose Intolerance ,Malabsorption Syndromes ,medicine ,Humans ,Lactose ,Bifidobacterium ,Lactose intolerance ,Gastroenterology ,Lactase ,Genetic Status ,PostScript ,medicine.disease ,biology.organism_classification ,Gut microbiome ,030104 developmental biology ,chemistry ,Immunology ,030211 gastroenterology & hepatology ,diet - Abstract
Lactose is the main source of calories in milk, an essential nutriedigestion, patients with visceral hypersensitivity nt in infancy and a key part of the diet in populations that maintain the ability to digest this disaccharide in adulthood. Lactase deficiency (LD) is the failure to express the enzyme that hydrolyses lactose into galactose and glucose in the small intestine. The genetic mechanism of lactase persistence in adult Caucasians is mediated by a single C→T nucleotide polymorphism at the LCTbo -13'910 locus on chromosome-2. Lactose malabsorption (LM) refers to any cause of failure to digest and/or absorb lactose in the small intestine. This includes primary genetic and also secondary LD due to infection or other conditions that affect the mucosal integrity of the small bowel. Lactose intolerance (LI) is defined as the onset of abdominal symptoms such as abdominal pain, bloating and diarrhoea after lactose ingestion by an individual with LM. The likelihood of LI depends on the lactose dose, lactase expression and the intestinal microbiome. Independent of lactose digestion, patients with visceral hypersensitivity associated with anxiety or the Irritable Bowel Syndrome (IBS) are at increased risk of the condition. Diagnostic investigations available to diagnose LM and LI include genetic, endoscopic and physiological tests. The association between self-reported LI, objective findings and clinical outcome of dietary intervention is variable. Treatment of LI can include low-lactose diet, lactase supplementation and, potentially, colonic adaptation by prebiotics. The clinical outcome of these treatments is modest, because lactose is just one of a number of poorly absorbed carbohydrates which can cause symptoms by similar mechanisms.
- Published
- 2022
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