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Inverse Dose Effect of Pretest Dietary Lactose Intake on Breath Hydrogen Results and Symptoms in Lactase Nonpersistent Subjects

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Abstract

The aim of this study was to determine a relationship between pretest intake of lactose and outcome of lactose breath hydrogen test. Patients presented at a testing laboratory participated in the study. A 3-hour breath hydrogen, 50-g lactose challenge was carried out. Results were tabulated and patients completed a 3-day recall diet questionnaire. Daily lactose intake was independently calculated and was associated with breath hydrogen and total symptom score. Statistical analysis used Spearman's correlation, Mann-Whitney U-test and χ2 or Fisher exact test. Of 118 patients, 50% were lactose maldigesters. In these patients, measured breath hydrogen and symptom scores were significantly higher in the lowest intake group (< 5 g/d) than in the highest intake group (> 20 g/d) (P < .05). In the presumed lactose digesters, 59% experienced some symptoms during testing for unclear reasons. Pretest dietary intake of lactose inversely affects results of breath hydrogen.

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References

  1. Habte D, Sterky G, Hjalmarsson B: Lactose malabsorption in Ethiopian children. Acta Paediatr Scand 62:649–654, 1973

    PubMed  Google Scholar 

  2. Sadre M, Karbasi K: Lactose intolerance in Iran. Am J Clin Nutr 32:1948–1954, 1979

    PubMed  Google Scholar 

  3. Suarez FL, Savaiano DA: Lactose digestion and tolerance in adult and elderly Asian-Americans. Am J Clin Nutr 59:1021–1024, 1994

    PubMed  Google Scholar 

  4. Villar J, Kestler E, Castillo P, Juarez A, Menendez R, Solomons NW; Improved lactose digestion during pregnancy: A case of physiologic adaptation? Obstet Gynecol 71:697–700, 1988

    PubMed  Google Scholar 

  5. Szilagyi A, Salomon R, Martin M, Fokeeff K, Seidman E: Lactose handling by women with lactose malabsorption is improved during pregnancy. Clin Invest Med 19:416–426, 1996

    PubMed  Google Scholar 

  6. Hertzler SR, Savaiano DA: Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance. Am J Clin Nutr 64:232–326, 1996

    PubMed  Google Scholar 

  7. Jiang T, Savaiano DA: In vitro lactose fermentation by human colonic bacteria is modified by Lactobacillus acidophilus supplementation. J Nutr 127:1489–1495, 1997

    PubMed  Google Scholar 

  8. Jiang T, Savaiano DA: Modification of colonic fermentation by bifidobacteria and pH in vitro. Impact on lactose metabolism, short-chain fatty acid, and lactate production. Dig Dis Sci 42:2370–2377, 1997

    Google Scholar 

  9. Ito M, Kimura M: Influence of lactose on faecal microflora in lactose maldigesters. Microb Ecol Health Dis 6:73–76, 1993

    Google Scholar 

  10. Gibson GR, Roberfroid MB: Dietary modulation of the human colonic microbiota: Introducing the concept of prebiotics. J Nutr 125:1401–1412, 1995

    PubMed  Google Scholar 

  11. Szilagyi A: Redefining lactose as a conditional prebiotic. Can J Gastroenterol 18:163–167, 2004

    PubMed  Google Scholar 

  12. Newcomer AD, McGill DB, Thomas PJ, Hofman AF: Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med 293:1232–1236, 1975

    PubMed  Google Scholar 

  13. Romagnuolo J, Schiller D, Bailey RJ: Using breath tests wisely in a gastroenterology practice: An evidence-based review of indications and pitfalls in interpretation. Am J Gastroenterol 97:1113–1126, 2002

    Article  PubMed  Google Scholar 

  14. Casellas F, Malagelada JR: Applicability of short hydrogen breath test for screening of lactose malabsorption. Dig Dis Sci 48:1333–1338, 2003

    Article  PubMed  Google Scholar 

  15. Metz G, Gassull MA, Leeds AR, Blendis LM, Jenkins DJ: A simple method of measuring breath hydrogen in carbohydrate malabsorption by end-expiratory sampling. Clin Sci Mol Med 50:237–240, 1976

    PubMed  Google Scholar 

  16. Van der Klei-van Moorsel JM, Douwes AC, van Oeveren JP: New principle for estimation of hydrogen in expired air. Eur J Pediatr 141:221–224, 1984

    Article  PubMed  Google Scholar 

  17. Strocchi A, Corazza G, Ellis CJ, Gasbarrini G, Levitt MD: Detection of malabsorption of low doses of carbohydrate: Accuracy of various breath H2 criteria. Gastroenterology 105:1404–1410, 1993

    PubMed  Google Scholar 

  18. Barr RG, Watkins JB, Perman JA: Mucosal function and breath hydrogen excretion: Comparative studies in the clinical evaluation of children with nonspecific abdominal complaints. Pediatrics 68:526–533, 1981

    PubMed  Google Scholar 

  19. Hertzler SR, Savaiano DA, Levitt MD: Fecal hydrogen production and consumption measurements. Response to daily lactose ingestion by lactose maldigesters. Dig Dis Sci 42:348–353, 1997

    Google Scholar 

  20. Chinda D, Nakaji S, Fukuda S, et al.: The fermentation of different dietary fibers is associated with fecal clostridia levels in men. J Nutr 134:1881–1886, 2004

    PubMed  Google Scholar 

  21. Cooper GS, Busby MG, Fairchild AP: Measurement of lactose consumption reliability and comparison of two methods. Ann Epidemiol 5:473–477, 1995

    Article  PubMed  Google Scholar 

  22. Kretchmer N: Lactose and lactase. Sci Am 227:71–78, 1972

    PubMed  Google Scholar 

  23. Scrimshaw NS, Murray EB: The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J Clin Nutr 48(4 Suppl):1079–1159, 1988

    Google Scholar 

  24. Cramer DW, Xu H: Lactase persistence galactose metabolism, and milk consumption as risk factors for ovarian cancer. Dyn Nutr Res 3(theme issue):52–60, 1993

    Google Scholar 

  25. Szilagyi A, Rivard J, Fokeeff K: Improved parameters of lactose maldigestion using lactulose. Dig Dis Sci 46:1509–1519, 2001

    Article  PubMed  Google Scholar 

  26. Zhong Y, Priebe MG, Vonk RJ, et al.: The role of colonic microbiota in lactose intolerance. Dig Dis Sci 49:78–83, 2004

    Article  PubMed  Google Scholar 

  27. Suarez FL, Savaiano DA, Levitt MD: A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. N Engl J Med 333:1–4, 1995

    Article  PubMed  Google Scholar 

  28. Vernia P, Marinaro V, Argnani F, Di Camillo M, Caprilli R: Self-reported milk intolerance in irritable bowel syndrome: What should we believe? Clin Nutr 23:996–1000, 2004

    Article  PubMed  Google Scholar 

  29. Suarez FL, Savaiano D, Arbisi P, Levitt MD: Tolerance to the daily ingestion of two cups of milk by individuals claiming lactose intolerance. Am J Clin Nutr 65:1502–1506, 1997

    PubMed  Google Scholar 

  30. Simren M, Mansson A, Langkilde AM, et al.: Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion 63:108–115, 2001

    Google Scholar 

  31. Corazza GR, Benati G, Strocchi A, Malservisi S, Gasbarrini G: The possible role of breath methane measurement in detecting carbohydrate malabsorption. J Lab Clin Med 124:695–700, 1994

    PubMed  Google Scholar 

  32. Rumessen JJ, Nordgaard-Andersen I, Gudmand-Hoyer E: Carbohydrate malabsorption: Quantification by methane and hydrogen breath tests. Scand J Gastroenterol 29:826–832, 1994

    PubMed  Google Scholar 

  33. Szilagyi A, Cohen A, Vinokuroff C, Ahmad D, Nathwani U, Yesovitch S: Deadaption and readaptation with lactose, but no cross-adaptation to lactulose: A case of occult colonic bacterial adaptation. Can J Gastroenterol 18:677–680, 2004

    PubMed  Google Scholar 

  34. Briet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud JC: Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: A placebo effect? Gut 41:632, 1997

    PubMed  Google Scholar 

  35. Rasinpera H, Savilahti E, Enattah NS, et al.: A genetic test which can be used to diagnose adult-type hypolactasia in children. Gut 53:1571–1576, 2004

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University, Montreal, Quebec, Canada

    Andrew Szilagyi MD, Paula Malolepszy BSc, Samara Yesovitch BA & Albert Cohen MD

  2. Department of Dietetics, Sir Mortimer B. Davis—Jewish General Hospital, McGill University, Montreal, Quebec, Canada

    Usha Nathwani PDt & Christina Vinokuroff PDt

  3. Department of Emergency Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University, Montreal, Quebec, Canada

    Xiaoqing Xue Msc

  4. Division of Gastroenterology, Department of Medicine, Sir Mortimer B. Davis—Jewish General Hospital, 3755 Cote Ste-Catherine, room G-327, Montreal, Quebec, Canada, H3T 1E2

    Andrew Szilagyi MD

Authors
  1. Andrew Szilagyi MD
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  2. Paula Malolepszy BSc
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  3. Samara Yesovitch BA
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  4. Usha Nathwani PDt
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  5. Christina Vinokuroff PDt
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  6. Albert Cohen MD
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  7. Xiaoqing Xue Msc
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Correspondence to Andrew Szilagyi MD.

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Szilagyi, A., Malolepszy, P., Yesovitch, S. et al. Inverse Dose Effect of Pretest Dietary Lactose Intake on Breath Hydrogen Results and Symptoms in Lactase Nonpersistent Subjects. Dig Dis Sci 50, 2178–2182 (2005). https://doi.org/10.1007/s10620-005-3028-4

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  • DOI: https://doi.org/10.1007/s10620-005-3028-4

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