Abstract
Background Insufficient vitamin D and calcium intake associated with the restricted intake of milk and dairy products can lead to poor health outcomes like malnutrition and abnormal bone mineralization. The aim of the study was to estimate the prevalence of primary and secondary lactose intolerance in children with IBD. Methods The study included 107 patients (mean age 14.07 ± 3.58 years; 46.7% boys) which includes 43 patients with Crohn's disease (CD), 31 with ulcerative colitis (UC), and 33 children with functional abdominal pain (AP-FGID). We analysed the result of the hydrogen breath test with lactose loading, two single nucleotide polymorphisms of the LCT gene (LCT-13910CC and LCT-22018GG). The results were analysed with MedCalc Statistical Software. Results Adult-type hypolactasia (ATH) was found in 31% of patients with IBD and 42.4% of AP-FGID (p = 0.2). Lactose malabsorption (LM) was found in 27.9% of patients with CD, in 22.6% with UC, and in 24.2% with AP-FGID (p = 0.8). Lactose intolerance (LI) was diagnosed in a similar percentage of patients in each group (p = 0.9). Secondary LI in IBD patients does not depend on the location, duration, and activity of the disease and the number of relapses (p > 0.05). The median time of lactose-free diet in CD was 10 months and in CU 24 months. Conclusions The incidence of LI, LM, and ATH does not differ among children with IBD from the population.
Highlights
Adult-type hypolactasia (ATH) is the most common cause of maldigestion and malabsorption of lactose [1, 2]
Among Europeans, two single nucleotide polymorphisms (SNP) were described upstream of the LCT gene; LCT13910CC and LCT-22018GG have been associated with ATH [4]
Mild disease was diagnosed in 14 children (45.2%), similar to the moderate disease in 14 children (45.2%)
Summary
Adult-type hypolactasia (ATH) is the most common cause of maldigestion and malabsorption of lactose [1, 2]. It is caused by genetically determined variability of enzymatic activity of lactase during human life. Typical symptoms of lactose intolerance (LI) are diarrhoea, bloating, abdominal pain, nausea, and vomiting. Their occurrence results from bacterial fermentation of undigested lactose by intestinal bacteria Bifidobacterium, Lactobacillus, and Streptococcus, having the enzyme beta-galactosidase. We analysed the result of the hydrogen breath test with lactose loading, two single nucleotide polymorphisms of the LCT gene (LCT-13910CC and LCT-22018GG). Adult-type hypolactasia (ATH) was found in 31% of patients with IBD and 42.4% of AP-FGID (p = 0:2). The incidence of LI, LM, and ATH does not differ among children with IBD from the population
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