Tolerance to small amounts of lactose in lactose maldigesters

Abstract

In this study we examined whether small doses of lactose induced symptoms in 39 lactose maldigesters and 15 lactose digesters in a randomized, crossover, double-blind design. The test doses were 200 mL fat-free, lactose-free milk to which 0, 0.5, 1.5, and 7 g lactose was added. Every third day of a lactose-free diet, after an overnight fast, the subjects drank one of the test milks in random order and registered the occurrence and severity of gastrointestinal symptoms in the next 12 h. During the study, the maldigesters reported significantly more abdominal bloating (P = 0.0003) and abdominal pain (P = 0.006) than the digesters. There was no difference in the mean severity of the reported symptoms between the test milks and the lactose-free milk in the group of lactose maldigesters, of whom one-third did not experience any symptoms from any of the test doses. The same proportion (64%) of the maldigesters experienced symptoms after both the lactose-free milk and the milk with 7 g lactose. However, the symptoms occurred inconsistently with the different test doses in 59% of the maldigesters. Thus, it can be concluded that the gastrointestinal symptoms in most lactose maldigesters are not induced by lactose when small amounts (0.5-7.0 g) of lactose are included in the diet.

Removing lactose from milk does not delay bowel function or harden stool consistency in lactose-tolerant women

“…Thus, lactose cannot be the reason for the increased symptoms. Similarly, several well-controlled studies have demonstrated that gastrointestinal symptoms after milk intake quite often occur independently of lactose intake (Rosado et al, 1987;Johnson et al, 1993;Vesa et al, 1996). It has been suggested that milk hypersensitivity in adults, which may be more common than previously thought, may cause gastrointestinal symptoms after milk intake (Pelto et al, 1998).…”

“…It has been suggested that milk hypersensitivity in adults, which may be more common than previously thought, may cause gastrointestinal symptoms after milk intake (Pelto et al, 1998). It is also well known that physiological factors, which are difficult to control, affect gastrointestinal symptoms (Vesa et al, 1996).…”

Molecularly defined adult-type hypolactasia among working age people with reference to milk consumption and gastrointestinal symptoms

“…The meal content has an effect on emptying of the stomach and thereby affects the lactose load in the Table 2 The frequency of gastrointestinal symptoms according to the three genotype groups of lactase persistence/nonpersistence during previous three months intestine [31,32] . Most lactose malabsorbers seem to tolerate small amounts of milk especially during meals [5,33] . Further studies are warranted to evaluate the amount of lactose tolerated by different genotype groups.…”

“…celiac disease [3] . Cases of individuals suspecting they have lactose intolerance are more common than the true prevalence of adult-type hypolactasia [4][5][6][7][8][9] . It has been shown that lactose-restricted diets improve symptoms markedly for example in IBS patients with lactose malabsorption and reduce the number of visits to the outpatient clinics [10] .…”

Should milk-specific IgE antibodies be measured in adults in primary care?

“…Yet, the test milk contained a small amount of lactose (B1 g/100 g) that is sufficient to induce symptoms related to lactose malabsorption in predisposed individuals [18]. Indeed, the only case that developed diarrhoea during the test had previously been confirmed to have a genotype associated with low intestinal lactase level and adult type hypolactasia [1] and thus was not manifesting an allergic gastrointestinal reaction.…”