Introduction The importance of lactose malabsorption in irritable bowel syndrome (IBS) is not well defined and these patients often complain of lactose intolerance. To objectively measure lactose malabsorption, a hydrogen breath test (HBT) can be performed, but a discrepancy emerges between the results of the HBT and the symptomatic response during the HBT. Aims To determine in a group of IBS patients whether self-perceived lactose intolerance and the symptomatic response to lactose HBT were conditioned by other factors besides the presence of lactose malabsorption. Materials and methods Oral challenge to lactose (50 g) was tested in 51 IBS patients to assess HBT malabsorption and the symptomatic response to lactose intolerance was scored on a validated questionnaire. Allergological screening for common inhalants and food allergens (including cow's milk) was performed. The presence of psychological factors (e. g. anxiety, depression, fatigue) was evaluated using validated questionnaires. Results A total of 21 out of 51 patients (41.1%) were self-perceived to be lactose intolerant, 24/51 (47%) had a positive HBT, and 14/51 (27.4%) presented with symptoms of lactose intolerance during HBT. The serological screening for inhalant and food allergens was positive in 6/21 (28.6%) and 4/21 (19%) of patients who self-perceived lactose intolerance and in 5/14 (37.5%) and 3/14 (21.4%) in intolerant patients symptomatic during HBT. Only 1/51 (1.9%) presented evidence of IgE-mediated hypersensitivity to cow's milk. Patients who experienced symptoms of lactose intolerance during HBT presented more severe IBS symptoms [326 (296-398) vs. 215 (126-295) P = 0.05] and a higher score of anxiety, depression, and fatigue. Factors influencing the symptoms of lactose intolerance during HBT resulted in an increase in hydrogen produced and in the severity of IBS. Conclusion In a cohort of 51 IBS patients, the symptoms of lactose intolerance during HBT were influenced by the capacity to absorb lactose and the severity of IBS. Other factors, such as the psychological status or an adverse reaction to milk, merit consideration as potential cofactors involved in lactose perception and tolerance. (C) 2014 Wolters Kluwer Health broken vertical bar Lippincott Williams & Wilkins.
机构:
Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
First Peoples Hosp Hangzhou, Dept Gastroenterol, Hangzhou, Zhejiang, Peoples R ChinaZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
Yang, J.
Fox, M.
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Univ Zurich Hosp, Div Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland
Queens Med Ctr, NIHR Nottingham Digest Dis Biomed Res Unit, Nottingham NG7 2UH, EnglandZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
Fox, M.
Cong, Y.
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Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R ChinaZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
Cong, Y.
Chu, H.
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Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R ChinaZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
Chu, H.
Zheng, X.
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Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R ChinaZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
Zheng, X.
Long, Y.
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Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R ChinaZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
Long, Y.
Fried, M.
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Univ Zurich Hosp, Div Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland
Univ Zurich, Zurich Ctr Integrat Human Physiol ZIHP, Zurich, SwitzerlandZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
Fried, M.
Dai, N.
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Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R ChinaZhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China