Abstract
Lactose malabsorption (LM), celiac disease (CD), non-celiac gluten sensitivity (NCGS), and irritable bowel syndrome (IBS) are conditions associated with food triggers, improvement after withdrawal, treatment with dietary restriction, and subsequent nutritional detriments. LM occurs when there is incomplete hydrolysis of lactose due to lactase deficiency and frequently produces abdominal symptoms; therefore, it can cause lactose intolerance (LI). A lactose-restricted diet is frequently recommended, although it can potentially lead to nutrient deficiencies. Furthermore, lactose is an essential component of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) and is subsequently associated with intolerance to these compounds, especially in IBS. LM commonly presents in CD. Nutritional deficits are common in CD and can continue even on a gluten-free diet (GFD). Conditions triggered by gluten are known as gluten-related disorders (GRDs), including CD, wheat allergy, and NCGS. IBS can also be associated with a gluten sensitivity. A GFD is the treatment for CD, GRDs, and gluten sensitive IBS, although compliance with this restricted diet can be difficult. Strict dietary therapies can have a negative effect on quality of life. This review aims to provide an overview of the difficult nutritional elements of these disorders, which are critical for medical providers to recognize when managing these patients.
Highlights
Lactose malabsorption (LM), celiac disease (CD), non-celiac gluten sensitivity (NCGS), and irritable bowel syndrome (IBS) are disorders characterized by the onset of symptoms from ingestion of a particular food and by relief after its elimination from the diet
CD is usually detected by serologic testing of celiac specific antibodies, tissue transglutaminase (TTG), endomysial antibody (EMA), and deamidated gliadin peptide (DGP), and the diagnosis is confirmed by endoscopic duodenal mucosal biopsies when villous atrophy is present [46,47]
Eliminating gluten in the diet is the treatment for gluten-related disorders (GRDs) and gluten sensitive IBS, compliance with the gluten-free diet (GFD) is challenging
Summary
Lactose malabsorption (LM), celiac disease (CD), non-celiac gluten sensitivity (NCGS), and irritable bowel syndrome (IBS) are disorders characterized by the onset of symptoms from ingestion of a particular food and by relief after its elimination from the diet. Patients with these disorders are placed on restricted diets. The aim of this review is to shed light on the nutritional aspects of LI, CD, NCGS, and IBS with an overview of these diseases and emphasis on practical issues in the management of patients Treatment of these conditions involves dietary restriction; it is crucial for clinicians to be aware that restricted diets can cause nutrient deficits, affect quality of life, and pose difficulties with compliance. Gluten, and irritable bowel currently present with evolving diagnostic measures, significant nutritional disadvantages, advancing methods in measuring diet adherence, and rising challenges in the long-term medical care of these patients
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