J Zhao1, M Fox, Y Cong, H Chu, Y Shang, M Fried, N Dai. 1. Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Abstract
BACKGROUND: Many studies report a high prevalence of lactose intolerance in patients with functional, gastrointestinal disease. AIM: To evaluate the role of small intestinal bacterial overgrowth (SIBO) in condition of lactose intolerance and the mechanism by which SIBO may impact lactose tolerance in affected patients. METHODS: Consecutive out-patients with chronic functional diarrhoea (CFD) and healthy controls underwent a validated 20 g lactose hydrogen breath test (HBT). Patients completed also a 10 g lactulose HBT with concurrent assessment of small bowel transit by scintigraphy. RESULTS: Lactose malabsorption was present in 27/31 (87%) patients with CFD and 29/32 (91%) healthy controls (P = 0.708). From the patient group 14/27 (52%) had lactose intolerance and 13/27 (48%) experienced no symptoms (lactose malabsorption controls). Only 5 (17%) healthy controls reported symptoms (P < 0.01). The oro-caecal transit time was similar between patient groups with or without symptoms (P = 0.969). SIBO was present in 11 (41%) subjects and was more prevalent in lactose intolerance than in lactose malabsorption [9/14 (64%) vs. 2/13 (15%), P = 0.018]. Symptom severity was similar in lactose intolerance patients with and without SIBO (P = 0.344). CONCLUSIONS: Small intestinal bacterial overgrowth increases the likelihood of lactose intolerance in patients with CFD as a direct result of lactose fermentation in the small intestine, independent of oro-caecal transit time and visceral sensitivity.
BACKGROUND: Many studies report a high prevalence of lactose intolerance in patients with functional, gastrointestinal disease. AIM: To evaluate the role of small intestinal bacterial overgrowth (SIBO) in condition of lactose intolerance and the mechanism by which SIBO may impact lactose tolerance in affected patients. METHODS: Consecutive out-patients with chronic functional diarrhoea (CFD) and healthy controls underwent a validated 20 g lactosehydrogen breath test (HBT). Patients completed also a 10 g lactulose HBT with concurrent assessment of small bowel transit by scintigraphy. RESULTS:Lactose malabsorption was present in 27/31 (87%) patients with CFD and 29/32 (91%) healthy controls (P = 0.708). From the patient group 14/27 (52%) had lactose intolerance and 13/27 (48%) experienced no symptoms (lactose malabsorption controls). Only 5 (17%) healthy controls reported symptoms (P < 0.01). The oro-caecal transit time was similar between patient groups with or without symptoms (P = 0.969). SIBO was present in 11 (41%) subjects and was more prevalent in lactose intolerance than in lactose malabsorption [9/14 (64%) vs. 2/13 (15%), P = 0.018]. Symptom severity was similar in lactose intolerance patients with and without SIBO (P = 0.344). CONCLUSIONS: Small intestinal bacterial overgrowth increases the likelihood of lactose intolerance in patients with CFD as a direct result of lactose fermentation in the small intestine, independent of oro-caecal transit time and visceral sensitivity.
Authors: Jian-Feng Yang; Mark Fox; Hua Chu; Xia Zheng; Yan-Qin Long; Daniel Pohl; Michael Fried; Ning Dai Journal: World J Gastroenterol Date: 2015-06-28 Impact factor: 5.742
Authors: Clive H Wilder-Smith; Xinhua Li; Sherry Sy Ho; Sai Mun Leong; Reuben K Wong; Evelyn Sc Koay; Ronaldo P Ferraris Journal: United European Gastroenterol J Date: 2014-02 Impact factor: 4.623
Authors: Benjamin Misselwitz; Daniel Pohl; Heiko Frühauf; Michael Fried; Stephan R Vavricka; Mark Fox Journal: United European Gastroenterol J Date: 2013-06 Impact factor: 4.623