How Effective Is Dietary Restriction in Patients with Fructose and Lactose Intolerance?

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Introduction: Dietary fructose and lactose intolerance are common causes of unexplained gas, bloating, and diarrhea. Limited data from research studies suggest that fructose and lactose dietary restriction is effective in treating these conditions. We aimed to assess the adherence and usefulness of dietary restriction in the treatment of fructose and lactose intolerance in clinical practice. Methods: Patients diagnosed with isolated fructose or isolated lactose intolerance with breath testing over 2 years were surveyed at the time of initial breath testing and at mean follow-up of six months. Patients with both fructose and lactose intolerance were excluded. The survey assessed symptoms of abdominal pain, cramping, bloating, fullness, nausea, belching, indigestion, diarrhea, and gas using a validated questionnaire and 3-point Likert scale and a global symptom score was calculated. At follow up, patients were surveyed regarding their adherence to the fructose and lactose restricted diets. Usefulness of dietary restriction was defined as >30% improvement in global symptoms. Results: One-hundred forty-eight patients (M/F = 30/118) with a mean age of 38 years were surveyed. Sixty of 148 (40.5%) patients with isolated lactose intolerance or isolated fructose intolerance responded. Thirty-one patients had fructose intolerance and 29 had lactose intolerance. 21 out of 31 (67.7%) patients with fructose intolerance continued dietary restriction of fructose while 20 out of 29 (69%) with lactose intolerance continued dietary restriction of lactose. A fructose-restricted diet was useful in 18 out of 31 (58.0%) patients with fructose intolerance, and a lactose-restricted diet was useful in 17 of 29 (58.6%) patients with lactose intolerance. There was significant improvement (P).Table 1: Symptoms of Fructose and Lactose Intolerance at Baseline and after Dietary InterventionConclusion: Approximately 58% of patients with either fructose or lactose intolerance adhere to dietary restrictions when provided by a Registered Dietitian. Dietary restriction is useful in fructose and lactose intolerance. Although dietary restriction helps, the lack of adherence in 42% of patients underscores the need for developing enzyme based alternative therapies.