Abstract
BackgroundSymptoms associated with lactose intolerance (LI) and diarrhea-predominant irritable bowel syndrome (IBS-D) are almost the same. These disease entities are difficult to differentiate clinically. In practice, differential diagnosis depends on self-reported patient milk intolerance. However, there is limited data on the prevalence of LI in China. The aim of this study was to investigate the prevalence of LI in IBS-D patients and asymptomatic healthy controls.MethodsLactose malabsorption (LM) was diagnosed by a lactose hydrogen breath test (HBT) and was defined by peak breath H2 excretion over the baseline level of ≥ 20 ppm. LI-related symptoms were monitored for 8 h following lactose administration. LI was defined in LM patients with positive symptoms during the observation time. Patients with IBS-D were additionally asked if they were intolerant to milk.ResultsA total of 109 eligible IBS-D patients (Rome III criteria) and 50 healthy controls were enrolled in this study. Except for hydrogen non-producers, the prevalence of LM did not differ between IBS-D patients and the control group (85%, 82/96 vs 72%, 34/47; P = 0.061). There was, however, a higher LI prevalence in IBS patients than in healthy subjects (45%, 43/96 vs 17%, 8/47; P = 0.002). Sensitivity, specificity, and positive and negative predictive values of self-reported milk intolerance for detecting LI were 58, 58, 53, and 63%, respectively.ConclusionsPrevalence of LI is significantly higher in IBS-D patients than in healthy subjects. Self-reported milk intolerance is a poor diagnostic predictor of LI.
Highlights
Symptoms associated with lactose intolerance (LI) and diarrhea-predominant irritable bowel syndrome (IBS-D) are almost the same
Irritable bowel syndrome (IBS)-D is associated with greater prevalence of LI The prevalence of Lactose malabsorption (LM) was high and comparable in both groups (IBS-D patients and healthy subjects)
There was greater prevalence of LI in IBS-D patients when compared to healthy subjects (Table 1)
Summary
Symptoms associated with lactose intolerance (LI) and diarrhea-predominant irritable bowel syndrome (IBS-D) are almost the same. These disease entities are difficult to differentiate clinically. Differential diagnosis depends on self-reported patient milk intolerance. The aim of this study was to investigate the prevalence of LI in IBS-D patients and asymptomatic healthy controls. Irritable bowel syndrome (IBS) is a common and global gastrointestinal disorder, and the pathogenesis of IBS is unclear [1]. Diarrhea-predominant IBS (IBS-D), a subtype of IBS which can present some similar symptoms with lactose intolerance (LI) such as abdominal pain, bloating, flatulence, and diarrhea, hampers differentiation between disease types [2]. The prevalence of LI in patients with IBS is unclear. Several recent studies have shown that selfreported milk intolerance in IBS patients is not reliable in predicting the outcome of a LI test [4, 10].further studies employing validated tools for diagnosing LI are necessary
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