The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: a 5-year follow-up study.

Abstract

DESIGN AND METHODS:

Prospectively, the effect of a lactose-restricted diet was evaluated among irritable bowel syndrome patients with lactose malabsorption. Lactose malabsorption was defined by a positive hydrogen breath test and a positive blood-glucose test. An analysis of symptoms was completed before, during, 6 weeks after and 5 years after starting the diet. In addition, the number of visits made by the patients to the outpatient clinic was scored during 6 years.

RESULTS:

In 17 out of 70 irritable bowel syndrome patients (24.3%), lactose malabsorption was detected. There was no difference in the symptom score between patients with a positive lactose tolerance test and patients with a negative lactose tolerance test. After 6 weeks of the lactose-restricted diet, symptoms were markedly improved in lactose malabsorption-positive patients (P < 0.001). After 5 years, one patient was lost for follow-up, and 14 out of the remaining 16 lactose malabsorption patients (87.5%) still had no complaints during the lactose-restricted diet. Two patients chose not to follow the diet continuously and accepted the discomfort caused by lactose intake. Only two out of 16 patients (12.5%) no longer experienced any benefit from lactose restriction. In the 5 years before their diagnosis of lactose malabsorption, these 16 patients visited the outpatient clinic a total of 192 times (mean 2.4 visits per year per person; range 1-7 visits). In the 5 years after diagnosis, they visited the outpatient clinic a total of 45 times (mean 0.6 visits per year per person; range 0-6 visits; P < 0.0001).

CONCLUSIONS:

In a large majority of irritable bowel syndrome patients with lactose malabsorption, which was previously clinically unrecognized, a lactose-restricted diet improved symptoms markedly both in the short term and the long term. Furthermore, visits by all patients to the outpatient clinic were reduced by 75%. We conclude that diet therapy is extremely cost- and time-saving. Therefore, it is strongly recommended that lactose malabsorption, which is easily treatable, is excluded before diagnosing irritable bowel syndrome.

• Authors: C J Böhmer, H A Tuynman
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 13 Issue 8 Pg. 941-4 (Aug 2001) ISSN: 0954-691X [Print] England
• PMID: 11507359 (Publication Type: Journal Article)

Chemical References

• Dietary Carbohydrates
• Lactose

Topics

• Adolescent
• Adult
• Ambulatory Care Facilities (statistics & numerical data)
• Colonic Diseases, Functional (diagnosis)
• Diagnostic Errors
• Dietary Carbohydrates (administration & dosage)
• Female
• Follow-Up Studies
• Humans
• Lactose (administration & dosage)
• Lactose Intolerance (diagnosis, diet therapy)
• Lactose Tolerance Test
• Male
• Middle Aged