Lactose Intolerance In Patients Research Articles

Self-Perceived Lactose Intolerance Versus Confirmed Lactose Intolerance in Irritable Bowel Syndrome: A Systematic Review.

Disorders of gut-brain interaction (DGBI) are prevalent, affecting 20-40% of the population, with irritable bowel syndrome (IBS) being the most common and impactful. While congenital lactose intolerance is rare, lactase deficiency in adults is widespread, causing gastrointestinal symptoms like bloating and diarrhea. Self-perceived lactose intolerance often overestimates symptoms, impacting dietary choices and quality of life, necessitating better understanding and management for improved patient outcomes. This article evaluates the diagnostic accuracy of self-reported lactose intolerance in patients with lactose intolerance and IBS through a systematic review. A systematic literature search was conducted using PubMed, EMBASE, and SCOPUS, including terms related to IBS, lactose intolerance, and self-reported symptoms, without applying filters to ensure comprehensive coverage. Inclusion criteria focused on observational studies with adult participants diagnosed with lactose intolerance, addressing symptoms and lactose malabsorption, while excluding non-English articles, reviews, editorials, and studies involving pediatric subjects. The systematic review analyzed six studies with 845 participants, revealing significant variability and moderate accuracy in self-reported lactose intolerance for diagnosing actual lactose intolerance in IBS patients. Hydrogen breath tests (HBTs) showed that self-reported symptoms often led to false positives, underscoring the need for objective diagnostic tools and standardized criteria. The findings highlight the complexity of diagnosing lactose intolerance in IBS patients and suggest that lactose-free diets and routine HBT should not be recommended without clear indications. The rigorous selection process ensured the inclusion of high-quality, relevant studies, thereby enhancing the reliability and validity of the review's findings. These studies revealed that a lactose-free diet should not be routinely recommended for IBS patients, nor should the routine use of HBT to identify lactose malabsorption in this group. Future research should focus on better understanding the factors influencing lactose perception and tolerance, which is crucial for more effective management of lactose intolerance in IBS patients.

The nutritional therapeutic values and chemical properties of goat milk

Goat is known as poor man’s animal. The fat globules are smaller in goat milk, which makes it easily digestible. Polyunsaturated fatty acids in goat milk fat, is mainly responsible for anticancerous behavior of goat milk. Although protein is somewhat low in goat milk than cow milk, the digestibility of goat milk protein is higher compared to cow milk protein. Taurine present in goat milk is reported to have inhibitory action on cardiovascular disease leads to synthesis of essential amino acids. Goat’s milk contains less lactose than cow’s milk, which is beneficial to lactose intolerance patients. Higher selenium concentration in goat milk, results in platelet regeneration when suffering from dengue fever. Bioactive peptides released during fermentation and invitro digestion are reported to produce antioxidant and antimicrobial peptides. Sialic acid present in caprine milk is also reported to help fast brain development. As compared to milk of other milch animals, goat’s milk has great potential to prevent various diseases. Beside nutritional properties, goat milk possesses potent nutraceutical and Therapeutic properties making it most suitable for infants, older and convalescent people. In this review, strong nutraceutical power of caprine milk is briefly explored.

Prevalence of Lactose Intolerance in Patients with Hashimoto Thyroiditis and Impact on LT4 Replacement Dose.

Purpose: to determine lactose intolerance (LI) prevalence in women with Hashimoto’s thyroiditis (HT) and assess the impact of LI on LT4 replacement dose. Methods. consecutive patients with HT underwent Lactose Breath Test and clinical/laboratory data collection. Unrelated gastrointestinal disorders were carefully ruled out. Lactose-free diet and shift to lactose-free LT4 were proposed to patients with LI. Results: we enrolled 58 females (age range, 23–72 years) with diagnosis of HT. In total, 15 patients were euthyroid without treatment, and 43 (74%) euthyroid under LT4 (30 of them with a LT4 formulation containing lactose). Gastrointestinal symptoms were present in 84.5% of patients, with a greater prevalence in change in bowel habits in lactose-intolerant patients (p < 0.0001). The cumulative LT4 dose required did not differ in patients with or without LI. No significant difference in both TSH values and LT4 dose were observed in patients shifted to lactose-free LT4 and diet at 3 and 6 months compared to baseline. Conclusion: the prevalence of LI in patients with HT was 58.6%, not different from global prevalence of LI. In the absence of other gastrointestinal disorders, LI seems not to be a major cause of LT4 malabsorption and does not affect the LT4 required dose in HT patients.

Serum Diamine Oxidase Values, Indicating Histamine Intolerance, Influence Lactose Tolerance Breath Test Results.

Lactose intolerance (LIT) is one of the major causes of irritable bowel syndrome (IBS) spectrum complaints. Differences in inadequate lactose digestion are described as various LIT phenotypes with basically unknown pathophysiology. In LIT patients, we retrospectively assessed the effect of histamine intolerance (HIT) on expiratory hydrogen (H2) during H2 lactose breath tests. In a retrospective evaluation of charts from 402 LIT patients, 200 patients were identified as having only LIT. The other 202 LIT patients were found to additionally have diamine oxidase (DAO) values of <10 U/mL, which indicates histamine intolerance (HIT). To identify HIT, standardized questionnaires, low serum DAO values and responses to a histamine-reduced diet were used. Patients were separated into three diagnostic groups according to the result of H2 breath tests: (1) LIT, with an H2 increase of >20 parts per million (ppm), but a blood glucose (BG) increase of >20 mg/dL, (2) LIT with an H2 increase of 20 ppm in combination with a BG increase of <20 mg/dL, and (3) LIT with an exhaled H2 increase of <20 ppm and BG increase of <20 mg/dL. Pairwise comparison with the Kruskal Wallis test was used to compare the areas under the curve (AUC) of LIT and LIT with HIT patients. Exhaled H2 values were significantly higher in H2 > 20 ppm and BG < 20 mg/dL patients with LIT and HIT (p = 0.007). This diagnostic group also showed a significant higher number of patients (p = 0.012) and a significant higher number of patients with gastrointestinal (GI) symptoms during H2 breath tests (p < 0.001). Therefore, low serum DAO values, indicating HIT, influence results of lactose tolerance breath tests.

Nutritional and nutraceutical properties of goat milk for human health: A review

Milk are considered as the best source of nutrients in well balanced ratio, and it also performs a number of beneficial biological activities in the human body that improves digestive system, metabolic activities to ingested nutrients, organ’s growth maintenance, development and resistance against diseases. Goats are considered to be the oldest domestic animals, domesticated for meat and milk and are known as the poor man's animal. Goat milk is nature's closest thing to perfect food. The constituent and composition of goat milk is totally different from cow or buffalo milk. Goat milk is nutritionally more or less matches to human milk which is not very much similar to cow's milk. It also possesses lots of medicinal properties. Lactose intolerance patients will be benefited from goat milk because it has less lactose than human and cow milk. It contains proteins, vitamins, minerals, fatty acids, trace elements and enzymes that can be easily assimilated in our body. Smaller and uniform fat globules of goat milk make them easily digestible in the body. It contains higher selenium concentration which acts on regeneration of blood platelet suffering from dengue fever. Protein content in goat milk is lower than cow milk and is easily digestible when compared to cow or buffalo milk. Taurine is present in goat milk which has inhibitory effect on hypertension, cardiovascular disease and synthesizes essential amino acids in human body. Asthma, anemia, stomach ulcers, constipation, sleeplessness, and neurotic indigestion have all been shown to be treated with goat milk. The goal of this review is to look at the differences in goat milk composition from cow and human milk, as well as the nutraceutical benefits on human health.

Helicobacter pylori infection and lactose intolerance increase expiratory hydrogen.

Infection with Helicobacter pylori (H.pylori) may cause dyspepsia and/or unexplained functional nonspecific, gastrointestinal complaints of the irritable bowel syndrome (IBS) spectrum. Hitherto, in H. pylori infected patients with symptoms of the IBS spectrum the occurrence of additional food intolerance/malabsorption is not evaluated. We used a retrospective analysis of charts from 548 patients who presented with gastrointestinal complaints of the irritable bowel syndrome spectrum. An enzyme-linked IgA immunosorbent assay or histologic evaluation of gastric mucosa were used to detect H. pylori infection. A hydrogen breath (H2) test was performed to evaluate fructose malabsorption (FM) and lactose intolerance (LIT). Serum diamine oxidase value of <10 U/ml and a response to a histamine-reduced diet was used to identify histamine intolerance (HIT). We found 293 patients infected with H. pylori, within these were 58 H. pylori patients with LIT, 23 H. pylori LIT patients with FM and 46 H. pylori LIT patients with HIT. Additionally, 13 H. pylori, lactose- and histamine intolerance patients also had FM. The Kruskal Wallis test and pairwise comparison were used to analyze differences of the area under the curve of expiratory hydrogen. In lactose H2 breath tests compared with LIT-only patients, LIT with H. pylori, LIT and H. pylori with HIT, LIT and H. pylori with FM showed significantly higher exhaled H2 levels (p=0.022). Pairwise comparison demonstrated H. pylori infected patients with LIT exhaled more H2 compared to LIT-only (p=0.029). H. pylori with lactose- and histamine intolerance, and H. pylori with lactose-, histamine intolerance and FM compared to H. pylori-only patients indicated a significantly higher occurrence of stomach pain during lactose H2 breath tests (p=0.012 and p=0.005, respectively). We demonstrate that LIT patients with high expiratory H2 levels in lactose breath tests may have H. pylori infection and possibly additional food intolerance/malabsorption. Subsequently, besides H. pylori eradication, a dietician is necessary for an individually tailored reduction- or exclusion diet of symptom triggering food components.

Formulation of Kattuyanam Rice Cupcake and its Quality Assessment

Cereal and pulse combination is considered as the staple food in the diet pattern, whereas refined or processed food consumption plays an important role in the occurrence of chronic lifestyle-related diseases. Cake is a sweet baked food made from refined flour and sugar, egg and fat. Consumers are gaining awareness about the importance of consuming healthy and wholesome foods. Hence, there is a felt need to develop plant-based, gluten-free and lactose-free cupcakes incorporating indigenous kattuyanam rice by completely replacing refined flour. Brown rice (Oryza sativa L.), also recognized as Kattuyanam rice is one of the traditional coloured rice variety which has immense nutrient potentials and improves human health. The present study was intended to formulate a plant-based cupcake that is rich in protein, fibre and calcium. The study also aimed at evaluating its nutritional composition, calculate its cost, and to assess the level of acceptability by subjecting to organoleptic evaluation. The plant-based cupcakes were formulated in three different ratios using each pulse variety and with kattuyanam rice. The two varied pulses used were horse gram dhal [A KHC (50:10), B KHC (40:20), C KHC (30:30)] and green gram dhal [D KGC (50:10), E KGC (40:20), F KGC (30:30)], the cakes were formulated and standardized without the addition of any artificial preservatives. Sensory evaluation of the cupcakes was carried out by a panel comprising of twenty members and the nine-point hedonic scale was used. The results of the sensory evaluation revealed that the kattuyanam rice cupcakes formulated in the ratio 30:30 [C KHC and F KGC] from both the variations had maximum overall acceptability score, these were subjected for further analysis. Results of the nutrient analysis revealed that the cupcakes were rich sources of protein, fibre and iron. The cupcakes were priced at twelve rupees per piece, making it economical. The formulated kattuyanam rice cupcake can be considered a viable solution for people with celiac, lactose intolerance patients, and the population adopting a vegan lifestyle.

Production of a novel probiotic date juice with anti-proliferative activity against Hep-2 cancer cells

Date fruit is the ancient discovered and consumed fruit. Worldwide, Egypt is the largest producer of date. Besides its health benefits, many recent studies have proved its antioxidant, anticancer and anti-inflammatory effect. Currently, probiotic fermented fruit juices have a great attention especially for lactose intolerance patients. This study assessed the survival of two probiotics (Lactobacillus acidophilus and L. sakei) in the date juice. Phenolics characterization was performed by HPLC. Anti-proliferative activity of fermented juice against Caco-2 and Hep-2 cell lines was also evaluated. Under cold storage, L. sakei was still live for 2 weeks at 1.8 x 107 CFU/mL. In contrast, L. acidophilus reduced from 5.2 x 106 CFU/mL to below the minimum value of probiotic products just after 1 week. L. sakie significantly multiplied the total phenols and antioxidant activity in the juice compared to the unfermented juice. Interestingly, probiotic date juice exhibited an antitumor activity against larynx cell lines (Hep-2) with no activity against Caco-2. Date juice was proved to be suitable for probiotic and as potential larynx anticancer juice. Therefore, the developed juice is recommended to contribute to the available probiotic foodstuffs.

Blinded Oral Challenges with Lactose and Placebo Accurately Diagnose Lactose Intolerance: A Real-Life Study.

Lactose intolerance (LI) is characterized by diarrhea, abdominal pain, or bloating occurring after lactose consumption in patients with lactose malabsorption. The National Institute of Health (NIH) proposed a double-blind placebo testing to identify LI individuals correctly. However, until now, no study used this approach in a real-life setting. We aimed to assess double-blind placebo challenge accuracy in diagnosing LI in patients with self-reported symptoms of LI. 148 patients with self-reported LI were consecutively enrolled and blindly underwent hydrogen breath test (HBT) after 25 g lactose or 1 g glucose (placebo) load. One week later, the subjects were challenged with the alternative substrate. Each subject completed a validated questionnaire, including five symptoms (diarrhea, abdominal pain, vomiting, bowel sounds, and bloating) scored on a 10-cm visual analog scale. Home questionnaire (HQ) referred to symptoms associated with the consumption of dairy products at home, while lactose questionnaire (LQ) and placebo questionnaire (PQ) referred to symptoms perceived throughout the 4-h after the administration of the substrates, respectively. After lactose load, HBT was positive in 81 patients (55%), of whom 60 (74%) reported relevant symptoms at LQ (lactose malabsorbers, LM). After placebo challenge, 45 out of 60 with a positive lactose challenge did not complain of symptoms and therefore were diagnosed as lactose intolerant, according to NIH definition. The blinded oral challenges with lactose and placebo accurately diagnose LI and identify patients who will likely benefit from a lactose-free diet.

Does fecal calprotectin increase may be linked to lactose intolerance in patients with irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a multifactorial condition without any specific investigation. Fecal calprotectin (FC) may be elevated in IBS without any explanation. In addition, some patients with IBS have symptoms related to lactose intolerance. Our main aim was to investigate whether an increase in FC could be related to lactose intolerance in patients with IBS. In this retrospective single-center study, all patients with IBS who have underwent a FC test and a lactose respiratory test within a period of less than 6 months were eligible. A FC greater than or equal to 50 μg/g was considered abnormal. Severnty-six patients (48 females), mean age 38±15 years were included. Symptoms were respectively: bloating in 57%, diarrhea in 76% and abdominal pain in 46% of cases. Among the 76 patients: 22 (29%) had FC≥50 μg/g and 9/22 (41%) had a positive lactose test. No significant relationship could be identified between the increase in FC and the lactose test positivity. The value of the FC was also not related to the subtype of IBS or the positivity of the glucose test. In our study, the increase in FC was not significantly related to the presence of lactose intolerance. Nevertheless, our work, despite its originality, is limited by its retrospective nature and small number of patients. Future studies including larger numbers of patients may identify the causes of elevated FC in patients with IBS to individualize different subgroups of patients to best adapt therapeutic management.

The effect of yogurt fortified with Lactobacillus acidophilus and Bifidobacterium sp. probiotic in patients with lactose intolerance.

This study assessed the effect of probiotic yogurt fortified with Lactobacillus acidophilus and Bifidobacterium sp. in patients with lactose intolerance. Fifty‐five patients suffering from lactose intolerance were randomly divided into control group of 28 lactose intolerance patients who received nonprobiotic yogurt (100 ml) and experimental group consisted of 27 lactose intolerance patients who received probiotic yogurt fortified (100 ml) with L. acidophilus and Bifidobacterium sp. Each individual received yogurt for one week. Lactose intolerance was confirmed when the patients received 75 g lactose and were positive after 30 min until 3 hr for lactose intolerance symptoms and by hydrogen breath test (HBT). After intervention, the hydrogen level was lower in experimental group in comparison with the control group. Lactose intolerance symptoms in experimental group were much less than the control group. Our findings revealed that probiotic yogurt fortified with L. acidophilus and Bifidobacterium sp. could safely and effectively decrease lactose intolerance symptoms and HBT, so our probiotic can be recommended as a treatment of choice in lactose intolerance patients.

Increasing Expiratory Hydrogen in Lactose Intolerance Is Associated with Additional Food Intolerance/Malabsorption.

Single and/or combined food intolerance/malabsorption may cause nonspecific, functional gastrointestinal (GI) complaints. In lactose-intolerant patients we evaluated the influence of additional food intolerance/malabsorption with hydrogen (H2) breath tests. In a retrospective analysis of charts from 279 lactose-intolerant patients, we found 128 patients with only lactose intolerance (LIT). Then, we identified 106 LIT patients with additional histamine intolerance (HIT). Additionally, 45 LIT and HIT patients also had fructose malabsorption (FM). A hydrogen (H2) breath test was performed to evaluate LIT and FM. A serum diamine oxidase value of <10 U/mL and a response to a histamine-reduced diet was used to identify HIT. Using pairwise comparison with the Kruskal–Wallis test to associate the area under the curve (AUC) of LIT patients and, LIT with HIT, to LIT with HIT and FM it was found, that the exhaled hydrogen values were significantly higher in patients with two-fold and triple combined food intolerance/malabsorption (p < 0.004 and p < 0.001, respectively). Within the pool of 170 LIT patients with >20 ppm increase of expiratory H2 from baseline, there were 74 LIT-only patients, 60 LIT with HIT patients, and 36 LIT patients with additional HIT and FM. With the Kruskal–Wallis test AUCs demonstrated a significant difference between all three groups (p = 0.024). In patients with LIT, the presence of additional food intolerance/malabsorption, significantly increases expiratory H2 values. We demonstrate evidence, which may suggest HIT to embody an own GI disorder as food intolerance/malabsorption.

Lactose intolerance in patients with inflammatory bowel diseases and dietary management in prevention of osteoporosis.

Lactose intolerance affects 33% to 75% of the world population and may be associated with various genetic factors. Lactose in the diet can be found in milk and dairy products, which simultaneously constitute the primary sources of calcium. Gut microbiota also influences lactose tolerance. Patients with lactose intolerance often stop consuming milk and dairy products, which may lead to calcium and vitamin deficiency and osteoporosis. Insufficient production of lactase also occurs in patients with diseases of the gastrointestinal tract, such as inflammatory bowel diseases. Moreover, Crohn's disease and ulcerative colitis are risk factors for osteoporosis, and the intake of the proper amount of calcium is an essential element in preventing the decrease of bone mineral density. Diet may prevent the development of osteoporosis, thus, educating patients regarding proper diet should constitute a part of the treatment and prevention process. Patients should consume low-lactose, or lactose-free milk and bacterially fermented dairy products. Additionally, plant milk supplemented by calcium and vitamin D, mineral water with calcium, and certain vegetables also may be good sources of calcium.

P-362 SIBO and lactose intolerance in patients receiving chemotherapy treatment for colorectal or gastric cancer

Worldwide, colorectal cancer (CRC) and gastric cancer (GC) are respectively the third and the fifth most prevalent cancers. Diarrhea (characterized by ≥3 episodes a day) is a common symptom in chemotherapy or radiotherapy treatment of GC or CRC cancer. Treatment-related diarrhea is the most common toxicity, which may reduce treatment tolerance. However, in addition to surgical resections and chemotherapy, changes in intestinal microbiota can lead to lactose intolerance and small intestinal bacterial overgrowth (SIBO), which cause diarrhea.

The Relationship Between Consumptions of Dairy and Fermented Dairy Products in Lactose Intolerance Among Students of A Foundation University In Istanbul

This study was conduct to determine the gastrointestinal symptoms after the consumption of milk and dairy products, lactose intolerance status and knowledge with Pre-school Teacher Education departments students at a Foundation University. The study was carried out with 200 female students on a voluntary basis. A data information form with 22 questions was applied to the participants. NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program was used for statistical analysis. General information, milk, milk products and foods that may contain lactose consumption frequencies, gastrointestinal symptoms such as abdominal pain, diarrhea, gas, bloating in the stomach, stomach cramping, vomiting and nausea after consumption of milk and fermented milk products like yoghurt, kefir, cheese were obtained via data information form. Monthly consumption of milk and dairy products of the participants, total energy, calcium, lactose amounts were calculated. . It was observed that the students consumed cheese and yoghurt more. Among those participating in the study, the rate of those who were diagnosed with a health care provider and had lactose intolerance was found to be 1%, while those who are suspected of lactose intolerance were 36%. It was found that 76.3% of the students who thought that they had lactose intolerance started to feel the symptoms later. The rate of lactose intolerance in patients with chronic disease compared to patients without chronic disease was found to be statistically significantly higher. When evaluated according to lactose intolerance after drinking milk, the distribution of the severity of the cases of abdominal pain, diarrhea, gas passing, stomach bloating, cramping and nausea show statistically significant difference. When the patients with and without lactose intolerance were compared, monthly calorie, lactose and calcium values from ayran and cheese were found to be statistically significantly lower in patients with lactose intolerance. It was seen that most of the students who experienced symptoms of lactose intolerance were not diagnosed and it was seen that the society should be made aware of this issue.

Diversity of Milks Other Than Cow, Sheep, Goat and Buffalo: In Terms of Nutrition and Technological Use

The first introduction of human being with milk begins with human milk during infancy, continues with very commonly with cow‘s milk and may be with other milk types during lifetime. Cow breeding and utilizing its milk in nutrition is widespread in the world. There are particular species common to their area such as donkey, camel, mare, yak and llama have an important share in milk production in the world. Donkey milk has higher serum protein and lower casein content being similar to human milk so regarded as a good and safer alternative for infants suffering from cow‘s milk protein allergy. Mare milk is used as a therapeutic agent for the treatment of some metabolic and allergic illnesses. It is generally consumed as fermented product. Llama milk contains higher amounts of calcium and phosphorus than cow's milk. Camel milk has high vitamin and mineral content and has claimed to have medicinal proteins. Its casein micelle size is larger naturally and it has lower amount of κ-casein these cause difficulties in cheese making and affect curd quality. Reindeer milk is an energy dense food with its high fat and high protein content when compared to cow‘s milk. Its high protein content could make it suitable for protein supplementation. Its low lactose content makes its consumption possible by lactose intolerance patients. Yak is richer in almost all main nutritional components when compared with cow‘s milk. It can be used in cheese, butter making and dried milk products. The objective of this review was to represent the composition of different animal species‘ milks; other than cow, buffalo, sheep and goat, their importance in nutrition and technological use.

LAKTOZ İNTOLERANSIN PREVALANSI, TEŞHİSİ VE LAKTOZSUZ BESLENME TAVSİYELERİ

Lactose is a disaccharide found only in milk, and after weaning, the synthesis of lactase, which breaks down lactose, stops or decreases in most individuals. This condition, known as lactose intolerance, results in the inability of the digestion of milk and is very common in the world. Because of the single nucleotide polymorphisms occurring on the lactase gene, the lactase enzyme can be synthesized for life in some individuals. The prevalence of this condition called lactase persistence varies according to ethnic groups. Although there are various methods for the diagnosis of lactose intolerance, observation of symptoms is often sufficient for the diagnosis of the disease. Those who have lactose intolerance should apply a life-long lactose-free diet. Since milk is a rich source of some important nutrients such as calcium, it is important for lactose intolerance patients to meet their needs like calcium from foods with low lactose content such as cheese and yogurt. In this study, information about lactose intolerance was given and lactose intolerance prevalence, diagnosis methods, and lactose-free diet were examined. This study aims to increase the lactose intolerance awareness of both patients and food industry stakeholders.

Prevalence of lactose intolerance in patients with diarrhea-predominant irritable bowel syndrome: data from a tertiary center in southern China

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.

PTH-248 The development of small intestinal bacterial overgrowth and lactose intolerance during modern pelvic chemoradiotherapy: Abstract PTH-248 Table 1

<h3>Introduction</h3> Diarrhoea is common during pelvic chemoradiotherapy and is multifactorial in origin. Previous studies show a rate of 26% small intestinal bacterial overgrowth (SIBO) and 15–44% lactose intolerance during the acute toxicity phase. However radiotherapy treatment has developed to provide more targeted treatment to the tumour, and spare organs at risk such as the small bowel. We aimed to determine the rate of SIBO and lactose intolerance in patients receiving newer techniques at our centre. <h3>Method</h3> This study was part of a trial evaluating the use of a gastrointestinal intervention for patients with cervical and bladder cancer receiving pelvic chemoradiotherapy. When patients developed lower gastrointestinal symptoms, hydrogen-methane breath tests were performed using the Quintron Breathtracker to detect SIBO and lactose intolerance. Demographic and treatment data were recorded in the trial documentation. <h3>Results</h3> Twenty patients had hydrogen methane breath testing for SIBO and 17 for lactose intolerance. Nine of these patients had cervical cancer and 11 had bladder cancer. Of the patients with bladder cancer, 10 were male. All patients received 20 fractions of radiotherapy over 4 weeks. See Table 1for full demographics. Glucose hydrogen methane breath testing was performed a median of 19 days after the start of radiotherapy and lactose hydrogen methane breath testing a median of 27 days after. SIBO was diagnosed in 21% (4/19) (1 test was inconclusive) by a rise in hydrogen in all cases. Of patients with cervical cancer 38% (3/8) had SIBO compared with 9% (1/11) patients with bladder cancer. Lactose intolerance was diagnosed in 29% (5/17) patients by a rise in hydrogen in all cases. Of the bladder group 30% (3/10) had lactose intolerance while 29% (2/7) of the cervix group tested positive. <h3>Conclusion</h3> The prevalence of SIBO and lactose intolerance in this study is similar to that previously described despite recent advances in radiotherapy treatment suggesting that new techniques do not reduce the risk of small bowel bystander effects. <h3>Disclosure of interest</h3> K. White Grant/ Research Support from: This poster presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0211–10024. The views expressed are those of the author (s) and not necessarily those of the NHS, the NIHR or the Department of Health., C. Henson: None Declared, J. Glennon: None Declared, S. Burden: None Declared, S. Lal: None Declared, S. Davidson: None Declared, J. McLaughlin: None Declared.

Small intestinal bacterial overgrowth as an uncommon cause of false positive lactose hydrogen breath test among patients with diarrhea-predominant irritable bowel syndrome in Asia.

It has been reported that small intestinal bacterial overgrowth (SIBO) may lead to false positive diagnoses of lactose malabsorption (LM) in irritable bowel syndrome patients. The aim of this study was to determine the influence of SIBO on lactose hydrogen breath test (HBT) results in these patients. Diarrhea-predominant irritable bowel syndrome patients with abnormal lactose HBTs ingested a test meal containing (99m) Tc and lactose. The location of the test meal and the breath levels of hydrogen were recorded simultaneously by scintigraphic scanning and lactose HBT, respectively. The increase in hydrogen concentration was not considered to be caused by SIBO if ≥ 10% of (99m) Tc accumulated in the cecal region at the time or before of abnormal lactose HBT. LM was present in 84% (31/37) of irritable bowel syndrome patients. Twenty of these patients agreed to measurement of oro-cecal transit time. Only three patients (15%) with abnormal lactose HBT might have had SIBO. The median oro-cecal transit time between LM and lactose intolerance patients were 75 min and 45 min, respectively (Z=2.545, P=0.011). Most of irritable bowel syndrome patients with an abnormal lactose HBT had LM. SIBO had little impact on the interpretation of lactose HBTs. The patients with lactose intolerance had faster small intestinal transit than LM patients.