Abstract:Background: Carbohydrate malabsorption is a frequent digestive problem associated with abdominal pain, bloating and diarrhea. Hydrogen breath testing (BT) represents the most reliable and validated diagnostic technique. The aim of this manuscript was to clarify the usefulness of BTs in the nutritional management of these disorders. Methods: A literature search for BT related to carbohydrate malabsorption was carried out using the online databases of Pubmed, Medline and Cochrane. Results: Lactose BT showed good… Show more
“…Absorption of lactose requires lactase-phlorizin hydrolase (LPH) activity in the small intestinal brush border. LM is directly caused by LPH deficiency, namely hypolactasia [ 2 , 3 , 4 , 5 , 6 ]. Hypolactasia comprises three distinct forms: congenital, primary and secondary [ 3 , 5 ].…”
Section: Lactose Malabsorption and Intolerancementioning
confidence: 99%
“…LM is directly caused by LPH deficiency, namely hypolactasia [ 2 , 3 , 4 , 5 , 6 ]. Hypolactasia comprises three distinct forms: congenital, primary and secondary [ 3 , 5 ].…”
Section: Lactose Malabsorption and Intolerancementioning
confidence: 99%
“…Primary hypolactasia occurs in a large proportion of the population, and it is the most frequent condition related to LM [ 5 ]. In particular, primary lactase deficiency is related to an autosomal recessive condition resulting from the physiological and progressive decline of lactase activity in the intestinal brush border [ 5 ]. A single nucleotide polymorphism, C/T-13910, has been correlated with lactase persistence or not persistence in several populations [ 5 , 8 ].…”
Section: Lactose Malabsorption and Intolerancementioning
confidence: 99%
“…As a consequence of an osmotic action that increases the volume of intestinal contents, the undigested lactose is fermented by the colonic flora, exacerbating digestive symptoms. Non-invasive hydrogen breath testing (BT) is generally considered the most reliable and recommended diagnostic technique [ 5 , 6 ] to detect LM. On the other hand, LI is not synonymous with LM.…”
Section: Introductionmentioning
confidence: 99%
“…In fact, only some patients with LM report symptoms. A blind lactose challenge should be the recommended method to objectively demonstrate LI [ 5 ]. A lactose-restricted diet and the use of pharmacological lactase supplements represent the recommended therapeutic strategy.…”
Background. Lactose malabsorption (LM) is a frequent clinical problem associated with several digestive and extra-digestive diseases. The aim of this manuscript was to clarify the real clinical impact of LM on these disorders. Methods. A literature search for digestive and extra-digestive disorders related to LM was carried out using PubMed, Medline and Cochrane. Results. A transient lactase deficiency is present in celiac disease (CD) on a normal diet. The persistence of symptoms in CD on a gluten-free diet may be instead, in part, attributed to a primary LM. Similar circumstances are present in inflammatory bowel diseases (IBD), in which LM can be responsible for a part of persistent symptoms in IBD on clinical remission. LM and irritable bowel syndrome (IBS) are instead independent conditions. On the other hand, a lactose-restricted diet may be useful for some IBS patients. A reduced lactose intake can lead to low bone mass and limited risk of fragility fractures. Finally, the absorption of levothyroxine could be conditioned by LM. Conclusions. LM can be responsible for persistent symptoms in CD and IBD. The association with IBS seems to be causal. Bone mass and levothyroxine absorption can be affected by LM.
“…Absorption of lactose requires lactase-phlorizin hydrolase (LPH) activity in the small intestinal brush border. LM is directly caused by LPH deficiency, namely hypolactasia [ 2 , 3 , 4 , 5 , 6 ]. Hypolactasia comprises three distinct forms: congenital, primary and secondary [ 3 , 5 ].…”
Section: Lactose Malabsorption and Intolerancementioning
confidence: 99%
“…LM is directly caused by LPH deficiency, namely hypolactasia [ 2 , 3 , 4 , 5 , 6 ]. Hypolactasia comprises three distinct forms: congenital, primary and secondary [ 3 , 5 ].…”
Section: Lactose Malabsorption and Intolerancementioning
confidence: 99%
“…Primary hypolactasia occurs in a large proportion of the population, and it is the most frequent condition related to LM [ 5 ]. In particular, primary lactase deficiency is related to an autosomal recessive condition resulting from the physiological and progressive decline of lactase activity in the intestinal brush border [ 5 ]. A single nucleotide polymorphism, C/T-13910, has been correlated with lactase persistence or not persistence in several populations [ 5 , 8 ].…”
Section: Lactose Malabsorption and Intolerancementioning
confidence: 99%
“…As a consequence of an osmotic action that increases the volume of intestinal contents, the undigested lactose is fermented by the colonic flora, exacerbating digestive symptoms. Non-invasive hydrogen breath testing (BT) is generally considered the most reliable and recommended diagnostic technique [ 5 , 6 ] to detect LM. On the other hand, LI is not synonymous with LM.…”
Section: Introductionmentioning
confidence: 99%
“…In fact, only some patients with LM report symptoms. A blind lactose challenge should be the recommended method to objectively demonstrate LI [ 5 ]. A lactose-restricted diet and the use of pharmacological lactase supplements represent the recommended therapeutic strategy.…”
Background. Lactose malabsorption (LM) is a frequent clinical problem associated with several digestive and extra-digestive diseases. The aim of this manuscript was to clarify the real clinical impact of LM on these disorders. Methods. A literature search for digestive and extra-digestive disorders related to LM was carried out using PubMed, Medline and Cochrane. Results. A transient lactase deficiency is present in celiac disease (CD) on a normal diet. The persistence of symptoms in CD on a gluten-free diet may be instead, in part, attributed to a primary LM. Similar circumstances are present in inflammatory bowel diseases (IBD), in which LM can be responsible for a part of persistent symptoms in IBD on clinical remission. LM and irritable bowel syndrome (IBS) are instead independent conditions. On the other hand, a lactose-restricted diet may be useful for some IBS patients. A reduced lactose intake can lead to low bone mass and limited risk of fragility fractures. Finally, the absorption of levothyroxine could be conditioned by LM. Conclusions. LM can be responsible for persistent symptoms in CD and IBD. The association with IBS seems to be causal. Bone mass and levothyroxine absorption can be affected by LM.
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