scholarly journals Blinded Oral Challenges with Lactose and Placebo Accurately Diagnose Lactose Intolerance: A Real-Life Study

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1653
Author(s):  
Alba Rocco ◽  
Debora Compare ◽  
Costantino Sgamato ◽  
Alberto Martino ◽  
Luca De Simone ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lactose Intolerance ◽  
Real Life ◽  
Hydrogen Breath Test ◽  
Double Blind ◽  
Lactose Malabsorption ◽  
Double Blind Placebo ◽  
Life Study ◽  
Validated Questionnaire ◽  
Real Life Setting

 Lactose intolerance (LI) is characterized by diarrhea, abdominal pain, or bloating occurring after lactose consumption in patients with lactose malabsorption. The National Institute of Health (NIH) proposed a double-blind placebo testing to identify LI individuals correctly. However, until now, no study used this approach in a real-life setting. We aimed to assess double-blind placebo challenge accuracy in diagnosing LI in patients with self-reported symptoms of LI. 148 patients with self-reported LI were consecutively enrolled and blindly underwent hydrogen breath test (HBT) after 25 g lactose or 1 g glucose (placebo) load. One week later, the subjects were challenged with the alternative substrate. Each subject completed a validated questionnaire, including five symptoms (diarrhea, abdominal pain, vomiting, bowel sounds, and bloating) scored on a 10-cm visual analog scale. Home questionnaire (HQ) referred to symptoms associated with the consumption of dairy products at home, while lactose questionnaire (LQ) and placebo questionnaire (PQ) referred to symptoms perceived throughout the 4-h after the administration of the substrates, respectively. After lactose load, HBT was positive in 81 patients (55%), of whom 60 (74%) reported relevant symptoms at LQ (lactose malabsorbers, LM). After placebo challenge, 45 out of 60 with a positive lactose challenge did not complain of symptoms and therefore were diagnosed as lactose intolerant, according to NIH definition. The blinded oral challenges with lactose and placebo accurately diagnose LI and identify patients who will likely benefit from a lactose-free diet. 

scholarly journals An engineered genetic circuit for lactose intolerance alleviation

BMC Biology ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mingyue Cheng ◽  
Zhangyu Cheng ◽  
Yiyan Yu ◽  
Wangjie Liu ◽  
Ruihao Li ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lactate Dehydrogenase ◽  
Lactose Intolerance ◽  
Genetic Circuit ◽  
Microbiota Composition ◽  
Galactosidase Activity ◽  
Lactose Malabsorption ◽  
Bacterial Cultures ◽  
Switch Circuit ◽  
Gut Microbiota Composition

Abstract Background Lactose malabsorption occurs in around 68% of the world’s population, causing lactose intolerance (LI) symptoms, such as abdominal pain, bloating, and diarrhea. To alleviate LI, previous studies have mainly focused on strengthening intestinal β-galactosidase activity while neglecting the inconspicuous drop in the colon pH caused by the fermentation of non-hydrolyzed lactose by the gut microbes. A drop in colon pH will reduce the intestinal β-galactosidase activity and influence intestinal homeostasis. Results Here, we synthesized a tri-stable-switch circuit equipped with high β-galactosidase activity and pH rescue ability. This circuit can switch in functionality between the expression of β-galactosidase and expression of L-lactate dehydrogenase in response to an intestinal lactose signal and intestinal pH signal, respectively. We confirmed that the circuit functionality was efficient in bacterial cultures at a range of pH levels, and in preventing a drop in pH and β-galactosidase activity after lactose administration to mice. An impact of the circuit on gut microbiota composition was also indicated. Conclusions Due to its ability to flexibly adapt to environmental variation, in particular to stabilize colon pH and maintain β-galactosidase activity after lactose influx, the tri-stable-switch circuit can serve as a promising prototype for the relief of lactose intolerance.

Beneficial therapeutic effect Lactobacillus GG in children with abdominal pain: A double-blind placebo-controlled control trial

2008 ◽  
Vol 40 (10) ◽  
pp. A92
Author(s):  
R. Francavilla ◽  
A.M. Magistà ◽  
V.L. Miniello ◽  
E. Lionetti ◽  
A. De Canio ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Therapeutic Effect ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Lactobacillus Gg

Levofloxacin for NIH Category II Chronic Bacterial Prostatitis: A Real-Life Study

Chemotherapy ◽  
2019 ◽  
Vol 64 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Vittorio Magri ◽  
Gianpaolo Perletti ◽  
Tommaso Cai ◽  
Konstantinos Stamatiou ◽  
Alberto Trinchieri ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Single Agent ◽  
Real Life ◽  
Symptom Index ◽  
Life Study ◽  
Treatment Groups ◽  
Urogenital Infections ◽  
Real Life Setting ◽  
Urological Procedures ◽  
Clinical Records

Background: Mounting worldwide resistance trends make the use of fluoroquinolone (FQ) antibacterial agents increasingly difficult. This is felt more acutely in the case of urogenital infections, which are mainly caused by Gram-negative pathogens. For years, levofloxacin and other FQs have been the first-line drugs for treating National Institutes of Health (NIH) category II chronic bacteria prostatitis (CBP). Eradication rates achieved by levofloxacin in the frame of randomized trials vary greatly, ranging between 71 and 86%. Objectives: This was a retrospective observational study to investigate the efficacy of levofloxacin against CBP in a real-life setting (urological outpatient wards). Methods: A database including the clinical records of >2,500 CBP patients was reviewed. Patients were selected based on strict inclusion criteria. They were treated for 4 weeks with 500 mg levofloxacin per day, alone or combined with other antibacterials. Besides standard urological procedures including the 4-glass test for pathogen isolation, international symptom questionnaires (the NIH Chronic Prostatitis Symptom Index [NIH-CPSI] and International Prostate Symptom Score [IPSS]) were administered. Results: Pathogen eradication was achieved in 79% of the cases treated with levofloxacin as a single agent and 87.8% of patients who received a combination of levofloxacin and azithromycin. The 11% increase in the eradication rate in the latter group is statistically significant. In addition, the levofloxacin-azithromycin combination caused a significant decrease in prostate volume and significantly increased the bladder-voided volume. IPSS and NIH-CPSI values and the urinary peak flow rate decreased to a similar extent in both treatment groups. No adverse effects were reported by patients belonging to either treatment group. Conclusion: Levofloxacin retained its therapeutic efficacy in patients assessed in a real-life setting, and high eradication rates were attained when it was administered as a single agent. A combination of an FQ with azithromycin induced a significant improvement of eradication rates. This strategy may be an interesting option in both first-referral and relapsing cases, although caution should be exercised when patients are at risk of developing arrhythmias, tendinitis, or other adverse effects.

scholarly journals Tolerance to low-digestible carbohydrates: symptomatology and methods

2001 ◽  
Vol 85 (S1) ◽  
pp. S17-S21 ◽  
Author(s):  
Philippe Marteau ◽  
Bernard Flourié
Keyword(s):  
Small Intestine ◽  
Breath Test ◽  
Absorption Capacity ◽  
Subjective Symptoms ◽  
Intersubject Variability ◽  
Intrasubject Variability ◽  
Hydrogen Breath Test ◽  
Experimental Conditions ◽  
Double Blind ◽  
Double Blind Placebo

Low-digestible carbohydrates (LDCs) are incompletely or not absorbed in the small bowel and fermented in the colon. They are usually well tolerated but may also have some dose-related undesirable effects due to their natural osmotic potential and/or excessive fermentation: borborygmi, excessive flatus, bloating, abdominal cramps and eventually diarrhoea. There is an important intersubject variability in the tolerance to LDCs because of differences in absorption capacity, motility pattern, colonic response and intestinal sensitivity. There is also a great intrasubject variability, depending on the type of LDC, dosage and type of consumption. Absorption of LDC in the small intestine can be assessed using hydrogen breath test or intubation techniques or analysis of ileostomy effluents. Double-blind, placebo-controlled studies are required to assess the subjective symptoms of intolerance, and the experimental conditions may influence the results.

Prevalence of Lactose Intolerance in Chile: A Double-Blind Placebo Study

Digestion ◽  
2014 ◽  
Vol 90 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Gonzalo Latorre ◽  
Pablo Besa ◽  
Carmen G. Parodi ◽  
Verónica Ferrer ◽  
Lorena Azocar ◽  
...  
Keyword(s):  
Lactose Intolerance ◽  
Double Blind ◽  
Double Blind Placebo
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