Abstract
Background: Some Finns report a diminution of milk-related gastrointestinal symptoms when they travel or live abroad. Change in the overall diet may explain the diminution of symptoms. Objective: The aim was to determine whether these symptomatic subjects are actually sensitive to indigestible carbohydrates found in a typical Finnish diet. Design: Nineteen symptomatic subjects whose milk-related symptoms decreased abroad were interviewed. Symptoms and hydrogen excretion were measured after ingestion of rye bread and xylitol in six symptomatic and nine control subjects. In addition, gastrointestinal symptoms during 3 day interventions with rye and wheat bread were studied in five symptomatic subjects. Results: The symptomatic subjects experienced more symptoms than the controls after rye bread and xylitol ingestion (p=0.0003, p=0.042). Breath hydrogen excretion was similar in both groups. The symptomatic subjects experienced more symptoms during the rye bread than the wheat bread intervention (p=0.036). Conclusion: Some individuals reporting milk-related gastrointestinal symptoms may actually react to indigestible carbohydrates in the diet. Keywords: gastrointestinal symptoms; lactose malabsorption; rye bread; xylitol
Highlights
Some adults claim to be intolerant to cow’s milk, even though neither lactose intolerance nor cow’s milk allergy can be diagnosed
According to Teuri et al [5], pseudohypolactasic subjects mistakenly believe that they have lactose malabsorption, but are reacting to indigestible carbohydrates
Nine volunteers with a good tolerance of Finnish milk and foods often related to gastrointestinal symptoms, i.e. rye bread, peas and onion, served as controls
Summary
Some adults claim to be intolerant to cow’s milk, even though neither lactose intolerance nor cow’s milk allergy can be diagnosed. The Finnish diet contains marked amounts of indigestible carbohydrates; for example, the average daily consumption of rye products, high in indigestible fibre, is 100 g in men and 66 g in women [1]. Indigestible carbohydrates, such as sweeteners [2, 3], fructo-oligosaccharides [4, 5] and galactooligosaccharides [6], have been observed to induce symptoms similar to those of lactose intolerance in some individuals, not in all [7, 8]. Conclusion: Some individuals reporting milk-related gastrointestinal symptoms may react to indigestible carbohydrates in the diet
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