Lactose malabsorption and lactose intolerance in adults - a cause of irritable bowel syndrome?

Åke Nilsson

doi:10.3402/fnr.v45i0.1805

Abstract

Gastroenterologists and general practitioners see many patients that have abdominal symptoms which are not explained when the patients are investigated for celiac disease, inflammatory bowel disease, peptic ulcer or tumours. The diagnosis is irritable bowel syndrome (IBS). Many of these patients report intolerance to certain foods including milk, and some develop symptoms after ingestion of lactose during the lactose tolerance test. In Northern European populations, lactose malabsorption is, however, not clearly overrepresented among the adult IBS patients, and subjective lactose intolerance is more common than IBS. Relatively few respond to a low-lactose diet on a long-term basis. Keywords: Irritable bowel syndrome, lactose intolerance, lactose malabsorption

Highlights

Irritable bowel syndrome (IBS) is a common symptomatic diagnosis which is troublesome for the patient
The question was raised early, whether lactose malabsorption is an important cause of symptoms and subjective food intolerance in irritable bowel syndrome (IBS) patients [1,2,3]
This article briefly summarizes some of the current knowledge about the relation between IBS, lactose intolerance and lactose malabsorption in adults seen from the gastroenterologist's point of view

Summary

Introduction

Irritable bowel syndrome (IBS) is a common symptomatic diagnosis which is troublesome for the patient. It is characterized by variable abdominal symptoms such as diarrhoea, obstipation, variable stool frequency, abdominal pain and flatulence. The severity of the symptoms varies between patients, and with time in the individual patients. In those with the most severe symptoms the condition is an important cause of incapacitation and sick leave. The question was raised early, whether lactose malabsorption is an important cause of symptoms and subjective food intolerance in IBS patients [1,2,3]. This article briefly summarizes some of the current knowledge about the relation between IBS, lactose intolerance and lactose malabsorption in adults seen from the gastroenterologist's point of view

The spectrum of IBS in adults

Mechanisms behind IBS

Findings

Conclusion