scholarly journals A laktózintoleranciáról: Múlt és jelen – I. rész

2015 ◽  
Vol 156 (38) ◽  
pp. 1532-1539
Author(s):  
György Miklós Buzás
Keyword(s):  
Breath Test ◽  
Lactose Intolerance ◽  
Tolerance Test ◽  
Diagnostic Methods ◽  
Chromosome 2 ◽  
Adult Type ◽  
Unequal Distribution ◽  
Bowel Diseases ◽  
Irritable Bowel ◽  
Lactase Gene

Lactose intolerance is the most prevalent intestinal malabsorption disorder. After presentation of its history, the author describes the emergence of lactose intolerance during the evolution of species, and the biochemistry of lactose as well as features of human and bacterial lactase enzymes are then described. The unequal distribution of lactose intolerance in different continents and population is discussed, followed by presentation of past and present prevalence data in Hungary. Adult-type hypolactasia is caused by a polymorphism of the MCM6 gene located upstream from the lactase gene on the long arm of the chromosome 2. It can be determined with the polymerase chain reaction. The intestinal symptoms of lactose intolerance are well known, but its extra-intestinal manifestations are less recognised. Invasive diagnostic methods (determination of lactase activity from small intestinal biopsies, lactose tolerance test), are accurate, but have been replaced by the non-invasive methods; their gold standard is the H2 breath test. Genetic testing is being used more and more frequently in Hungary too, and, presumably, the methane breath test will be also available in the near future. Lactose intolerance can be accompanied by inflammatory bowel diseases, coeliac disease and irritable bowel syndrome; it could be established whether this association is causal or not in order to start a correct diet and therapy. Orv. Hetil., 2015, 156(38), 1532–1539.

scholarly journals Lactose intolerance, lactose malabsorption and genetic predisposition to adult-type hypolactasia in patients after restorative proctocolectomy

2019 ◽  
Author(s):  
Jarosław Walkowiak ◽  
Ewa Fidler-Witoń ◽  
Aleksandra Glapa ◽  
Jacek Paszkowski ◽  
Maciej Borejsza-Wysocki ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Genetic Predisposition ◽  
Breath Test ◽  
Lactose Intolerance ◽  
Adenomatous Polyposis ◽  
Adult Type ◽  
Lactose Malabsorption ◽  
Significant Difference ◽  
Lactase Gene

This study provides up-to-date findings on lactose malabsorption, lactose intolerance and genetic predisposition to adult-type hypolactasia in 72 patients after restorative proctocolectomy (RPC). The lactose malabsorption was assessed by hydrogen-methane breath test. Genetic predisposition to adult-type hypolactasia was assessed by detecting –13910T/C polymorphism in the lactase gene. Lactose intolerance was more frequent in UC (ulcerative colitis) patients than FAP (familial adenomatous polyposis) patients (77.5% vs. 55.2%; p=0.01). The C/C genotype of the lactase gene was observed in 39.1% subjects with no significant difference between UC and FAP patients. Lactose malabsorption occurred in 10.1% of subjects and almost only in patients with genetic predisposition, with the same frequency in UC and FAP patients.

scholarly journals Congruency of Genetic Predisposition to Lactase Persistence and Lactose Breath Test

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1383 ◽  
Author(s):  
Enza Coluccia ◽  
Patrizia Iardino ◽  
Diego Pappalardo ◽  
Anna Lisa Brigida ◽  
Vincenzo Formicola ◽  
...  
Keyword(s):  
Breath Test ◽  
Lactose Intolerance ◽  
Genetic Test ◽  
Gastrointestinal Symptoms ◽  
Diagnostic Procedures ◽  
Clinical Syndrome ◽  
Clinical Use ◽  
Genotype C ◽  
Lactase Gene ◽  
Genotype A

The physiological decline of lactase production in adulthood, in some individuals, is responsible for the so-called “Lactose Intolerance.” This clinical syndrome presents with gastrointestinal and non-gastrointestinal symptoms following the consumption of dairy containing food. Lactose intolerance can be evaluated by means of the Lactose Breath Test (phenotype) and/or genetic evaluation of lactase-gene polymorphism (genotype). A comparison of the two tests was carried out in a large number of symptomatic adult subjects, which are selected and not representative of the general population. Congruency was as high as 88.6%. Among lactase non-persistent (genotype C/C), 14 subjects showed a negative Lactose Breath Test (LBT), possibly due to young age. Among lactase-persistent (genotype C/T), four subjects showed a positive LBT, which helps to diagnose secondary lactose intolerance. Symptoms, both gastrointestinal and extra-gastrointestinal, were reported by 90% of patients during the breath test. Clinical use of both tests in the same patients could be taken into consideration as a sharp diagnostic tool. We suggest considering the use of the genetic test after LBT administration, when secondary hypolactasia is suspected, for completion of diagnostic procedures.

scholarly journals Absorptive function of the small intestine at chronic inflammatory bowel diseases

2009 ◽  
Vol 8 (4(2)) ◽  
pp. 39-44
Author(s):  
V. A. Burkovskaya ◽  
E. I. Beloborodova ◽  
L. A. Akimova ◽  
Ye. L. Naumova ◽  
O. N. Glinskaya ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Small Intestine ◽  
Tolerance Test ◽  
Main Process ◽  
Absorption Function ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Chronic Inflammatory Bowel ◽  
Healthy Persons

The absorption function of small intestine has been studied at chronic inflammatory intestine diseases anв assessed depending on the severity of the main process. In groups of patients with ulcerative colitis, Crohn’s disease, and irritable bowel syndrome, as well as in healthy persons, diurnal fat loss with feces was determined by the van de Kamer method, and the D-xylose tolerance test was performed. The disorder of nutrient absorption in patients with chronic inflammatory intestinal diseases is directly proportional to the severity of the main disease.

scholarly journals Irritable bowel syndrome and small intestinal bacterial overgrowth: Assessment with breath test

2020 ◽  
pp. 041-048
Author(s):  
LA Costa ◽  
TNF Gomes ◽  
CU Braga ◽  
L Lenz ◽  
SJ Miszputen ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Breath Test ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Diagnostic Methods ◽  
Intestinal Bacterial Overgrowth ◽  
Exhaled Air ◽  
Baseline Values ◽  
Small Intestinal ◽  
Irritable Bowel

Background: Irritable bowel syndrome (IBS) has been considered a functional disease, however evidences suggest organic abnormalities as disbiosis. The aim of this study was to evaluate bacterial overgrowth syndrome in IBS patients. Methods: Patients with IBS were submited to the expired H2 and CH4 breath test, with analyzes of exhaled air in fasting (zero minutes) and after the administration of 10g of lactulose, at times: 15, 30, 60, 90, 120, 150 and 180 minutes. The test was considered positive when the values of H2 or CH4 at 90 minutes were 20 ppm above baseline values. Results: Fourth-six patients were included, 23 (50%) had diarrheal subtype, 12 (26.1%) had constipated subtype and 11 (23.9%) had mixed subtype. All patients were submitted to lactulose breath test (LBT), with evaluation of expired H2 and CH4. The H2 test positivity was 15.2% and the CH4 test was 10.9%. In the diarrheal subgroup, the positivity of the H2 test was 13%, and at the CH4 test was 8.7%. Among the constipated patients, 16.7% were positive for H2 test, and none was positive for CH4 test. At the mixed subtype, the H2 test was positive for 18.2% and CH4 test for 27.3%. There was no significant correlation between the positivity of expired H2 test with the diarrheal subtype, and neither the expired CH4 test with the constipated subtype. Conclusion: LBT has not altered in patients with three forms of IBS. The optimization of diagnostic methods is necessary for a more accurate diagnosis.

scholarly journals Laktózintolerancia: a laktázgén C/T-13910 polimorfizmusának és a hidrogénkilégzési teszt pontosságának retrospektív kiértékelése gasztroenterológiai szakrendelésen

2016 ◽  
Vol 157 (25) ◽  
pp. 1007-1012 ◽  
Author(s):  
György Buzás ◽  
Flóra Fodor ◽  
Béla Csókay
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Breath Test ◽  
Genetic Test ◽  
Kappa Index ◽  
Adult Type ◽  
Breath Tests ◽  
Set Up ◽  
Lactase Gene

Introduction: Adult type hypolactasia is the most prevalent carbohydrate malabsorption. Aim: To assess the distribution of lactase gene C/T-13910 polymorphism and the accuracy and concordance of a genetic test and H2 breath test in the diagnosis of adult type hypolactasia. Method: 496 patients with symptoms of lactose intolerance were enrolled in a retrospective study who underwent genetic test using TaqMan polymerase chain reaction and H2 breath test. Results: The prevalence of C/T-13910 genotypes was: CC 48.1%, TC: 40.5%, and TT: 11.4%. When the genetic test was taken as reference, the sensitivity of the breath test was 84.3%, with a specificity of 95.7%, a positive predictive value of 96.7% and negative predictive value of 80.4%. Conversely, the accuracy of genetic test was: sensitivity 96.6%, specificity 80.4%, positive predictive value 84.3% and negative predictive value 95.7%. The concordance value between the two tests (kappa index) was 0.78. The results were discordant in 11.1% of the cases. Conclusions: In symptomatic patients, the lactase non-persistence genotype CC occurred in almost half of the patients. Both the genetic and the breath tests are sufficiently accurate, with good predictive value and they can be used to set up the diagnosis. Discordant results should be carefully interpreted. Orv. Hetil., 2016, 157(25), 1007–1112.

scholarly journals ANALYSIS OF LACTOSE INTOLERANCE IN STUDENTS WITH SUGGESTIVE SYMPTOMS OF IRRITABLE BOWEL SYNDROME

2019 ◽  
Vol 56 (3) ◽  
pp. 304-311
Author(s):  
Cleise de Jesus SILVA ◽  
Ingrid Dantas Sampaio LEITE ◽  
José Weberton RODRIGUES ◽  
Samara Pereira de ALMEIDA ◽  
Bruna Pessoa NÓBREGA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Breath Test ◽  
Gastrointestinal Symptom ◽  
Lactose Intolerance ◽  
Gastrointestinal Symptoms ◽  
Bacterial Overgrowth ◽  
Irritable Bowel ◽  
Carbohydrate Intolerance

ABSTRACT BACKGROUND: Irritable bowel syndrome is a clinical condition presenting pain, distension and abdominal fullness, diarrhea, constipation, and other symptoms. It generates significant impacts on the quality of life of those affected. The pathophysiology is uncertain, but the role of various food types has been established in bowel sensitivity and its clinical manifestations. Carbohydrate intolerance, particularly to lactose, generates similar and sometimes indistinguishable symptoms from irritable bowel syndrome, and in clinical practice is both a frequent and underdiagnosed condition. Carbohydrate intolerance is related to enzymatic deficiencies, alterations of intestinal microbiota and even genetic change. The principal test for a diagnosis of lactose intolerance is the breath test, which measures hydrogen emission (produced only by bacteria), after ingestion of the corresponding substrate. OBJECTIVE: The present work aims to verify the prevalence of lactose intolerance in university students, presenting gastrointestinal symptoms suggestive of irritable bowel syndrome. METHODS: In a transversal study, to screen for those with suggestive symptoms, 124 medicine students participated by responding to a form. Those with abdominal pain were referred for anti-parasite treatment in order to exclude intestinal parasites as a secondary cause. Subsequently, using the hydrogen breath test, bacterial overgrowth was investigated, and if negative, lactose intolerance testing would be performed. Patients presenting high hydrogen concentrations of ≥20 ppm above the basal level were considered lactose intolerant. RESULTS: Of the total of students researched (n=124), 7 were excluded because they did not completing all study phases. From those 117 individuals effectively included in the survey; 8 (6.8%) were diagnosed with lactose intolerance and 2 (1.7%) with bacterial overgrowth. Intolerance was more frequent in; female individuals (75%), age range 18 to 25 years (62.5%), being colored (50%), and in their 5th semester of studies (37.5%). The presence of at least one gastrointestinal symptom among those presenting intolerance (100%), and those not presenting intolerance (42.2%) was found (P=0.002). In addition to abdominal pain (100%) (P<0.001), the most recurrent gastrointestinal symptom in the lactose intolerant students was the distension/flatulence (62.5%) (P=0.026). In relation to life habits and food patterns, there was no statistical difference between lactose tolerant and intolerant individuals, or for symptom frequencies. The more advanced students, completing more periods towards graduation, demonstrated more occurrences of gastrointestinal symptoms, yet without presenting significant statistical discrepancies. CONCLUSION: In view of the test sample quantity (n=21), a high prevalence of lactose intolerance (6.8%) in the academic environment, with epidemiological characteristics compatible to those found the literature is demonstrated, generating knowledge with understanding to prevent, diagnose, alleviate and treat lactose intolerant university students, and generate positive impacts towards well-being, improving the quality of life of these individuals.

scholarly journals Lactose Intolerance—Old and New Knowledge on Pathophysiological Mechanisms, Diagnosis, and Treatment

2021 ◽  
Vol 3 (2) ◽  
pp. 499-509
Author(s):  
Roberto Catanzaro ◽  
Morena Sciuto ◽  
Francesco Marotta
Keyword(s):  
Lactose Intolerance ◽  
Bacterial Flora ◽  
Gastrointestinal Symptoms ◽  
Short Chain Fatty Acids ◽  
Tolerance Test ◽  
Diagnostic Methods ◽  
Hydrogen Breath Test ◽  
Increased Risk ◽  
Instrumental Methods ◽  
Osmotic Load

AbstractLactose intolerance is a pathology frequently encountered today. It occurs when the activity of lactase in the intestine is reduced or absent, with consequent failure to digest lactose. The global prevalence of this clinical condition is estimated of about 57% with instrumental methods, while the real prevalence exceeds 65%. The absence of lactase determines both the excessive osmotic load in the small intestine and the fermentation of lactose by the bacterial flora with consequent production of short-chain fatty acids and gas. This latter process is responsible for the onset of symptoms associated with lactose intolerance (abdominal pain, bloating, flatulence, etc.) which arise after the intake of lactose. Several studies have shown an increased risk of developing various pathologies for lactose-intolerant subjects (some types of cancer, osteoporosis, etc.). Therefore, it is essential to diagnose and properly treat this pathology. Various options exist for diagnosing lactose intolerance: Hydrogen Breath Test, genetic test, Quick Lactose Intolerant Test, Lactose Tolerance Test, Gaxilose Test. Like diagnostic methods, there are several options for treating intolerance. In addition to a food restriction, the use of exogenous enzymes and/or probiotic and the selection of milk containing specific types of beta-caseins less correlated to the appearance of gastrointestinal symptoms are very useful. The aim of this review is to illustrate the main and most modern diagnostic and therapeutic choices for lactose intolerance currently available.

scholarly journals Lactose intolerance in children and adults

2020 ◽  
Vol 54 (3) ◽  
pp. 105-112
Author(s):  
Momčilo Pavlović ◽  
Nedeljko Radlović ◽  
Karolina Berenji ◽  
Bogdan Arsić ◽  
Željko Rokvić
Keyword(s):  
Dairy Products ◽  
Lactose Intolerance ◽  
Calcium Supplementation ◽  
Fermented Milk ◽  
Tolerance Test ◽  
Hydrogen Breath Test ◽  
Adult Type ◽  
Abdominal Colic ◽  
Allergy Treatment ◽  
Milk And Dairy Products

Lactose is a disaccharide found in milk and dairy products. Children and adults with lactose intolerance are unable to tolerate significant amounts of lactose because of an inadequate amount of the enzyme lactase. The condition occurs in three main types: primary, secondary, and primary adult-type hypolactasia. The use of milk in the diet of these individuals may lead to appearance of the irritable bowel syndrome. In persons with lactose intolerance symptoms include diarrhoea, dominated by abdominal colic, loud peristaltic sounds, increased flatulence and meteorism. A diagnosis of lactose intolerance can usually be made with a careful history, elimination of lactose from the diet, lactose tolerance test, hydrogen breath test and genetic testing. In the absence of appropriate tests in patients with suspected primary adult-type hypolactasia, diagnosis can be made as in patients with food allergy. Treatment is based on the restriction of lactose intake with the use of fermented milk products. However, especially for children, if milk and dairy products are eliminated from the diet, it is important to ensure D vitamin and calcium supplementation.

scholarly journals Lactose Malabsorption and Lactose Intolerance in Children with Inflammatory Bowel Diseases

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Martyna Jasielska ◽  
Urszula Grzybowska-Chlebowczyk
Keyword(s):  
Lactose Intolerance ◽  
Bone Mineralization ◽  
Nucleotide Polymorphisms ◽  
Functional Abdominal Pain ◽  
Hydrogen Breath Test ◽  
Adult Type ◽  
Single Nucleotide ◽  
Lactose Malabsorption ◽  
Bowel Diseases ◽  
Inflammatory Bowel

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.

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