European Journal of Gastroenterology & Hepatology

Accession Number<strong>00042737-200103000-00001</strong>.
AuthorParker, Tracy J. a; Woolner, Jenny T. a; Prevost, Andrew T. b; Tuffnell, Quita a; Shorthouse, Maria a; Hunter, John O. a
Institution(a)Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK; and (b)Centre for Applied Medical Statistics, Department of Public Health and Primary Care, University of Cambridge, UK
TitleIrritable bowel syndrome: is the search for lactose intolerance justified?[Article]
SourceEuropean Journal of Gastroenterology & Hepatology. 13(3):219-225, March 2001.
AbstractObjectives: To determine if confirmation of hypolactasia offers any benefit to the dietary treatment of patients with irritable bowel syndrome (IBS).

Methods: One hundred and twenty-two consecutive IBS patients (37 male, 85 female) were given lactose hydrogen breath tests (LHBT). Those with positive LHBT followed a low lactose diet for 3 weeks. Those improving on the diet were given double-blind, placebo-controlled challenges (DBPCC) with 5 g, 10 g and 15 g of lactose and a placebo, to confirm lactose intolerance. Those who did not respond to the low lactose diet followed either an exclusion or low fibre diet. Symptoms scores were kept prior to the LHBT, 8 h post-LHBT and daily whilst following any dietary change. Patients with negative LHBT returned to clinic and subsequent dietary interventions were recorded.

Results: LHBT was positive in 33/122 (27%) IBS patients. Symptom scores prior to LHBT were not significantly different between the two groups, but after LHBT the symptoms in the positive group were significantly worse. Twenty-three patients followed a low-lactose diet of which only nine (39%) improved. Six who did not improve followed an exclusion diet, three improved and all were intolerant of milk. Three tried a low fibre diet with two improving. DBPCC were inconclusive. In the negative LHBT group 35 agreed to try a diet and 24 improved (69%). Eight were intolerant of cow's milk.

Conclusions: Use of a low lactose diet was disappointing in IBS patients with lactose malabsorption. Food intolerance was demonstrated in IBS patients with positive or negative LHBT and milk was identified as a problem in both groups. DBPCC were inconclusive. There appears to be little advantage in trying to separate patients who malabsorb lactose from others with IBS.

(C) 2001 Lippincott Williams & Wilkins, Inc.