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PubMed1979

A boy with severe infantile gastrogen lactose intolerance and acquired lactase deficiency.

A 10-year-old boy with severe familial lactose intolerance in infancy (vomiting, failure to thrive, lactosuria (5.25 g/l), sucrosuria (12 g/l), and aminoaciduria. Intestinal disaccharidases (including lactase and sucrase) normal at age 6 and 20 weeks. Oral lactose tolerance test at this age resulted in lactosuria (4.6 g/l); sucrose tolerance test, in sucrosuria (18.5 g/l). In contrast, intraduodenal lactose tolerance test gave only low lactose excretion in urine (0.28 g/l). He improved rapidly and had no lactosuria on intraduodenal feeding with citric acid milk. The lactosuria diminished as age increased, but was still higher at age 6 years than that of controls. He tolerated normal disaccharide containing food after 1.5 years of age. At 5.5 to 6 years, he had symptoms of lactose malabsorption, and an isolated lactase deficiency was proved. At 10 years, he still tolerates only limited amounts of milk. The defect in severe familial infantile lactose intolerance seems to be localized in the gastric mucosa. Acquired lactase deficiency can appear later in childhood in this syndrome.

Amino Acids↗

PubMed1992

The status of lactose absorption in Hong Kong Chinese children.

Lactose malabsorption was investigated in 169 Chinese children aged between two and 16 years using the breath hydrogen test. The challenge was either lactose solution (1 g/kg) or cow's milk (10 ml/kg). Overall, 68% of the children showed a significant increase in breath hydrogen following the lactose challenge while only 17% showed an increase after the cow's milk challenge and 13% after both challenges. The number of malabsorbers increased significantly (p less than 0.001) with age and no associated gastrointestinal symptoms or signs were found in any of the children following the challenges, suggesting a gradual and partial loss of intestinal lactase activity. We conclude that the prevalence of lactose malabsorption in Hong Kong children is very high using the standard lactose tolerance test but when a more realistic amount of lactose and a natural medium such as a glass of milk is used as the challenge, the number of malabsorbers becomes small and clinically insignificant.

Adolescent↗

PubMed1981

Lactose malabsorption during gastroenteritis, assessed by the hydrogen breath test.

Thirty-eight infants and young children with gastroenteritis were investigated for lactose malabsorption. Each of them was given an oral lactose load of either 0.5 g/kg or 2 g/kg after which breath hydrogen excretion was measured, and each was observed to see if he had clinical symptoms of lactose intolerance. Only one patient, given 2 g/kg lactose, had clinical intolerance. His breath hydrogen excretion however was negative. Three of 18 patients given 0.5 g/kg lactose had positive breath hydrogen tests. None of these was symptomatic. Lactose intolerance in gastroenteritis was rare in our study, and the hydrogen breath test was not an appropriate technique for detecting it.

Breath Tests↗

PubMedDate not supplied

Possible therapeutic use of loperamide for symptoms of lactose intolerance.

OBJECTIVES: To examine a potential practical therapeutic use of loperamide (Lo) to decrease the symptoms of lactose intolerance. SUBJECTS AND METHODS: Nineteen (eight men, 11 women) healthy lactose maldigesters (18 of 19 with symptoms) underwent a 25 g lactose challenge on five separate days. Breath hydrogen was measured, areas under the curve (AUC) were calculated for 4 h, and 4 and 12 h symptom scores were recorded. After establishing baseline measurements, test doses of 4 mg, 8 mg and 12 mg Lo were randomly administered without placebo in a double-blind manner. As well, each subject received seven lactase tablets, in a random, unblinded manner. RESULTS: The median AUC and mean oral cecal transit time followed dose response expectations; however, only lactase treatment achieved significance. Nevertheless, 8 mg Lo significantly improved symptom scores, which were statistically indistinguishable from those of lactase. Four subjects complained of delayed constipation and cramps with various doses of Lo. CONCLUSIONS: Lo monotherapy for lactose intolerance is not economical and may have some side effects. However, Lo may be studied further as an adjunctive treatment of lactose intolerance in an effort to reduce the need for complete lactose digestion. Such a manoeuvre may allow rapid colonic adaptation, which in turn may be beneficial for prophylaxis for a number of colonic diseases.

Adolescent↗

PubMed2004

Redefining lactose as a conditional prebiotic.

Lactose in dairy products is maldigested by up to 70% to 75% of the world's population and many people may therefore suffer symptoms reminiscent of irritable bowel syndrome. As a result, most research to date has concentrated on ways of improving lactose tolerance to enhance dairy as a source of nutrition. However, research on other possible benefits of lactose and its maldigestion has lagged. In view of an exponential growth in the understanding of intestinal microfloral host interactions and the expanding therapeutical potential of probiotics, a reassessment of the role of lactose as a potential prebiotic in lactase nonpersistent subjects is required. Gibson and Roberfroid introduced the concept of prebiotics and outlined definitive requirements for such a compound. The present article examines scientific and clinical knowledge about the properties of lactose and argues that in lactase nonpersistent subjects, lactose qualifies as a prebiotic.

Animals↗

PubMed1991

Concordance of indirect methods for the detection of lactose malabsorption in diabetic and nondiabetic subjects.

In order to collect data on (1) the prevalence of lactose malabsorption and (2) the value of indirect diagnostic methods for hypolactasia in diabetics, we compared lactose tolerance tests using serum glucose, serum galactose (after oral ethanol intake) and breath hydrogen excretion as diagnostic cutoff in 144 nondiabetic and 46 diabetic subjects. A good rate of concordance was found for the hydrogen breath test and galactose-dependent lactose tolerance test. The glucose-dependent lactose tolerance test was found to be of satisfactory diagnostic value in nondiabetic subjects and was useless for diagnostic purposes in diabetics. Lactose malabsorption was no more frequent in diabetics than in controls and lactose intolerance was found to be less frequent in the diabetic group. A distinction between hypolactasia and other gastrointestinal disorders in diabetics is possible by ambulatory indirect tests.

Adult↗

PubMed1997

Properties of porcine and yogurt lactobacilli in relation to lactose intolerance.

Lactobacilli that had been isolated from the stomach of piglets were tested for properties relevant to the production of fermented milk products for consumption by lactose-intolerant humans. The strains were characterized for beta-galactosidase activity, the ability to reduce the lactose concentration of milk, viability, and pH of the fermented milk over a 30-d period. Strains that had favorable attributes were studied further, and the optimal pH for beta-galactosidase activity, ability to grow in the presence of bile salts, and ability to deconjugate bile salts were determined. Commercial yogurts were also examined to determine whether products varied in characteristics that might affect tolerance of milk products by lactose-intolerant subjects. The Lactobacillus sp. isolated from pigs had lower beta-galactosidase activity than did Lactobacillus delbrueckii ssp. bulgaricus strains ATCC 11842 and NCDO 1489 and strains of lactobacilli isolated from yogurt. The beta-galactosidase activity of all strains decreased rapidly once the fermented milk was stored at 4 degrees C. Strain JB10, originating in the stomach contents of the piglets, had properties that were useful for the manufacture of fermented milk products for lactose-intolerant humans. Milk fermented by this strain had a lactose concentration of about 4.0% and contained 6.6 x 10(6) cfu/ml after storage at 4 degrees C for 20 d. Strain JB10 produced a beta-galactosidase that was active at pH 5.5 (35% of the activity at pH 7.0) and was not inhibited by the presence of bile acids in the culture medium. Beta-Galactosidase activity and lactose concentration varied among yogurts.

Animals↗

PubMedDate not supplied

Lactose maldigestion in different age groups of north Indians.

Lactase activity with age has been reported in a wide variety of population globally. However, most of these studies in human have ignored to assess age stratified lactose maldigestion. Therefore, the present study was planned to determine lactose maldigestion in different age groups of north Indians adults. Two hundred apparently healthy north Indians (age rage 10-80 years) were subjected to a 50g lactose hydrogen breath test by standard method using a Model 12 Microlyzer from Quintron, USA. The percentage of lactose maldigestion was calculated for different age groups with an interval of 10 years. The results of this study revealed that the frequency of lactose maldigestion did not differ significantly among the age groups. Thus, this study suggests that lactose maldigestion is not associated with age stratification among north Indians.

Adolescent↗

PubMed2006

[Research advancement about lactose intolerance].

Lactose intolerance associated with nutrition and health of human especially infant period of time and effect milk product intake. It is important significance to maintain health and cut down the aged risk of osteoporosis because lactose intolerance was understand about grouping, clinical symptom and diagnose. There are extensive perspective for understand prevent and control lactose intolerance for lactose gene polymorphism. It is effective method for earlier period detection gene screen with lactose typing for osteoporosis, however there are carry out multiplicity research in many ways to improve and control lactose intolerance

Humans↗

PubMed1990

Prevalence of lactose malabsorption among patients with functional bowel disorders.

To investigate the prevalence of lactose malabsorption among patients with functional gastrointestinal disturbances we prospectively evaluated all patients referred to a gastrointestinal outpatient clinic over a period of 18 months. All patients had a breath hydrogen test following oral lactose in addition to the standard diagnostic procedures. In 37 of the total of 64 patients no organic cause of the gastrointestinal complaints was found. In 9 of these 37 patients (24%) the breath hydrogen test indicated lactose malabsorption. Three to 6 month later most of the patients with lactose malabsorption showed a significant reduction of gastrointestinal complaints after they had maintained a lactose-poor diet. In comparison, patients with functional disturbances but without lactose malabsorption reported nor or only minor improvement of symptoms; most of these patients had consulted another physician since the last visit in the clinic.

Breath Tests↗

PubMed1987

Effective reduction of lactose maldigestion in preschool children by direct addition of beta-galactosidases to milk at mealtime.

We examined the efficiency of two beta-galactosidase preparations--one derived from the yeast, Kluyveromyces lactis (Lactaid), the other derived from the fungus, Aspergillus oryzae (Takamine)--to assist the in vivo digestion of lactose consumed by healthy Guatemalan preschool children. Milk prehydrolyzed by in vitro incubation with enzymes was used as the standard of reference, and the degree of incomplete digestion of lactose from 240 mL of milk was determined using the hydrogen breath test. In in vivo dose-response studies, both 3,250 neutral lactose units of Lactaid and 6,635 food and chemical codex lactose units of Takamine completely eliminated excess H2 excretion in a small sample of lactose-maldigesting subjects. When evaluated in a controlled, clinical trial setting, the same dose of Lactaid added directly to the milk at consumption produced an 82% relative reduction in H2 excretion, whereas Takamine was equally as effective as the prehydrolyzed milk. Thus, intraluminal conditions and gastrointestinal transit in the preschool child support the effective assisted digestion of milk lactose in an efficient manner and with the same enzyme to milk ratios as observed previously in adults.

Animals↗

PubMedDate not supplied

[Adaptation of rats, after weaning, to a diet with a high concentration of lactose. I. Evaluation of water and diet ingestion].

Twelve female Wistar rats, weaned at 21 days, were allocated in two groups: Lactose Group composed by six rats receiving a normal laboratory diet added with 25 g of lactose for each 100 g of final mixture, and the Saccharose Group that was fed with the same diet but with the lactose being replaced by saccharose in the same proportion; both groups were studied for 28 days. The rats were weighed at the beginning of the experiment and on the 7th, 14th, 21st and 28th days; the relative ingestion of water and diet was evaluated for each animal on the same days except for the first. During the observation period weight gain was significantly lower on the Lactose Group compared to the Saccharose Group, although this difference became less evident towards the end of the experiment. In the Lactose Group the diet ingestion was higher on the 21st and 28th days opposed to the water ingestion which was higher on the 7th and 14th days. The results here presented suggest that, in spite of the ontogenic fall of intestinal lactase in rats, these animals can, even after weaning, accommodate to high doses of dietary lactose, by using adaptative pathways which deserve further investigation.

Adaptation, Physiological↗

PubMed1978

Tolerance to lactose among lactase-deficient American Indians.

To determine the amount of lactose that could be tolerated in a meal, 59 lactase-deficient American Indians, ranging in age from 5 to 62, were given graded doses of lactose. The diagnosis of lactase deficiency had beeen documented previously by showing increased breath hydrogen after an oral lactose load (2 g per kg, maximum 50 g). With this load, 88% of the subjects had symptoms. On 6 consecutive mornings, each subject was given a breakfast that contained graded doses of lactose ranging from 0 to 18 g. The order of the breakfasts was randomized and the contents were double-blinded. Symptoms, which were assessed by a "blinded" observer, were present after 9% of the breakfasts at all dosage levels, including the lactose-free breakfast. Thus, under the conditions of this study, a modest amount of lactose, equivalent to that present in 1 to 1 1/2 glasses of milk, when taken with a meal, is well tolerated by the lactase-deficient American Indian.

Adolescent↗

PubMed1983

Lactose intolerance in adults with chronic unspecific abdominal complaints.

77 hospitalized patients with chronic unspecific abdominal complaints, in whom any other organic disease had been previously excluded, were investigated for lactose malabsorption; they were subdivided into two groups: 46 patients complaining primarily of colicky abdominal pain and/or intermittent diarrhoea (group 1) and 31 patients presenting with dyspepsia as the predominant symptom (group 2). To establish the exact prevalence of isolated lactase deficiency in the healthy adult population served by our hospital, 40 Italian adult healthy subjects were also studied. The prevalence of lactose malabsorption was significantly higher (p less than 0.005) in patients of the 1st group than in patients of the 2nd group, and in the healthy adult population seen at our hospital (74% vs 35.5% and 37.5%, respectively). Furthermore a high prevalence of lactose intolerance, determined by means of a three-week diet trial (lactose free-diet versus normal diet), was documented among lactose malabsorbers of the 1st group. We concluded therefore that lactose intolerance is a factor in some Italian adult patients who suffer from long-standing aspecific abdominal discomfort, and it should be always considered in these patients, especially when colicky abdominal pain and diarrhoea are present, before the diagnosis of irritable bowel syndrome is made.

Abdomen↗

PubMedDate not supplied

[Primary lactose malabsorption in healthy Brazilian adult caucasoid, negroid and mongoloid subjects].

A lactose tolerance test consisting of the administration of 50 g lactose as a 10% aqueous solution was applied to 80 healthy adult individuals from Campinas, SP., Brazil (40 caucasoids, 20 negroids and 20 mongoloids of Japanese ancestry) with no secondary lactase deficiency. Lactose malabsorption was manifested by 45% caucasoids, 85% negroids and 100% mongoloids. The lactose malabsorption as assessed by the lactose loading test was more closely associated with symptoms of lactose intolerance (cramps, meteorism and diarrhea) than with fecal alterations (acid pH, as well as detectable glucose and reducing substances in the feces).

Adult↗

PubMed1981

Recurrent abdominal pain and lactose absorption in children.

The association of lactase deficiency with recurrent abdominal pain was investigated. One hundred three white children between the ages of 6 to 14 years with recurrent abdominal pain were evaluated. Sixty-nine underwent lactose tolerance tests and 26 had intestinal biopsies with lactase determinations; 21 of 69 (30.4%) had abnormal lactose tolerance tests and eight of 26 (31%) were lactase deficient. However, 16 of 61 (26.4%) control subjects matched for age and ethnic background exhibited lactase deficiency. Thus, a similar prevalence of lactase deficiency was found in the control and the recurrent abdominal pain groups. Thirty-eight patients with recurrent abdominal pain completed three successive six-week diet trials conducted in a double-blind fashion. An increase above base line value in pain frequency was seen in ten of 21 (48%) lactose malabsorbers and four of 17 (24%) lactose absorbers. After a 12-month milk elimination diet, six of 15 (40%) malabsorbers and five of 13 (38%) absorbers had elimination of their pain. This result compared with improvement occurring in five of 12 (42%) absorbers with recurrent abdominal pain who received a regular diet for one year and suggests that the elimination of lactose will not affect the overall frequency of improvement in recurrent abdominal pain. In addition, the recovery rate from recurrent abdominal pain is similar in both lactose absorbers and nonabsorbers independent of dietary restrictions.

Abdomen↗

PubMedDate not supplied

[Urinary lactose determination].

The authors suggests a modified method for nonchromatographic measurement of urinary lactose. The minimal detectable lactose volume is 0.5 g/l. Eighty-four children, mostly babies, with lactose intolerance were examined, breast-fed or formula-fed with lactose-containing mixtures. Lactosuria was detected in 27.4% of the examinees. Urinary lactose levels were (mean +/- m) 0.69 +/- 0.02 g/l. No lactosuria was detected by this method in 29 babies without lactose tolerance (control group).

Breast Feeding↗

PubMedDate not supplied

[Poor digestion and intolerance to lactose in Mexican adults. Importance of evaluating them with regular doses of milk].

Lactose digestion capacity after ingestion of habitual doses of milk and its effect on milk intolerance and consumption were studied in 205 mexican adults. In a double-blind study, subjects received two treatments involving the intake of 360 mL of intact whole milk and the same amount of 90% lactose-hydrolyzed milk. Lactose maldigestion was determined by the hydrogen breath analysis test and was detected in 31.5% of the subjects. Symptoms of milk intolerance were present in only 9.5% of the study population. The prevalence lactose maldigestion and intolerance in mexican adults is lower than previous values reported using pharmacological doses of lactose. No effect of lactose intolerance on habitual consumption of milk was detected.

Adolescent↗