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Query: KEGG:D00046 (lactose)
 16,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent investigations of pathogenesis of the irritable bowel syndrome (IBS) either suggested psychopathology as the cause of bowel symptoms or proposed abnormalities in colonic motor and myoelectrical activity. Therefore, we prospectively compared clinical symptoms, personality traits, subjective stress reports, and motor and myoelectrical activity of the sigmoid colon and rectum in patients with IBS, patients with lactose malabsorption (LMA) who had not consulted a doctor for bowel complaints, and normal subjects. It could be shown that neither colonic activity nor stress distinguished patients with IBS from those with LMA. Patients with IBS exhibited significantly more clinical symptoms and psychopathology than patients with LMA and normal subjects. These findings suggest that psychopathology does not cause the symptoms or results from bowel dysfunctions but determines who will consult a doctor for bowel complaints.
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PMID:[Clinical symptoms, psychopathology and intestinal motility in patients with "irritable bowel"]. 277 31

The relationship between abdominal pain and bowel gas from bacterial fermentation of undigested carbohydrate was investigated in nine patients with irritable bowel syndrome (IBS), six lactose malabsorbers, and 11 asymptomatic controls. All subjects took breath samples and marked analog scales for abdominal pain, bloating, and psychological stress hourly during all waking hours for 7 days. Breath samples were analyzed for hydrogen concentration within 3 days, and the concentration was corrected for storage time. Symptoms of pain and bloating were significantly more common in IBS patients than in lactose malabsorbers or normal controls, and pain was significantly correlated with bloating in IBS patients. Breath hydrogen concentration was similar in all three groups, and breath hydrogen was not correlated with pain ratings in IBS patients. Thus, abdominal pain may be related to bloating from gastrointestinal gas, but bacterial fermentation cannot be the cause of such gas. The most likely source is swallowed air. This study also demonstrates the feasibility of monitoring hydrogen production in the bowel in field studies by having subjects collect hourly breath samples.
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PMID:Intestinal gas production from bacterial fermentation of undigested carbohydrate in irritable bowel syndrome. 292 57

The clinical symptoms of patients with the irritable bowel syndrome (ICS) frequently do not differ according to present findings from those of patients with lactose malabsorption. To test this observation further in a gastroenterological out-patient clinic, the authors compared the clinical symptoms, psychological features and motor activity in the rectosigmoid in 20 patients with ICS and 21 with lactose malabsorption. It was found that the intestinal symptoms, intestinal motor activity and psychopathology of patients with ICS was nonspecific and occurred equally frequently as those in the malabsorption patients. This casts doubt on the view that psychological factors play a role in the pathogenesis of ICS.
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PMID:[Psychosomatic aspects of irritable bowel syndrome. Specificity of clinical symptoms, psychopathological features and motor activity of the rectosigmoid]. 334 45

Women with symptoms indicative of irritable bowel syndrome who had not consulted a physician were compared with female patients at a gastroenterology clinic to investigate whether self-selection for treatment accounts for psychologic abnormalities in clinic patients' with irritable bowel syndrome. Two sets of diagnostic criteria were compared: restrictive criteria based on the work of Manning and conventional criteria (abdominal pain plus altered bowel habits). Lactose malabsorbers were included as a control group because they have medically explained bowel symptoms similar to those that define irritable bowel syndrome. Thus they control for the causative effects of chronic bowel symptoms on psychologic distress. Women who met restrictive criteria for irritable bowel syndrome but had not consulted a physician had no more symptoms of psychologic distress on the Hopkins Symptom Checklist than asymptomatic controls. However, medical clinic patients with both irritable bowel syndrome and lactose malabsorption had significantly more psychologic symptoms than asymptomatic controls or nonconsulters with the same diagnoses. Individuals who met only the conventional criteria for irritable bowel syndrome reported more psychologic distress than controls, whether or not they consulted a physician. These results suggest that (a) symptoms of psychologic distress are unrelated to irritable bowel syndrome but influence which patients consult a doctor and (b) conventional diagnostic criteria identify more psychologically distressed individuals than do restrictive criteria.
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PMID:Symptoms of psychologic distress associated with irritable bowel syndrome. Comparison of community and medical clinic samples. 339 18

Lactose malabsorption was studied by the hydrogen breath-test in 23 adults suffering from irritable bowel syndrome (group A) and in 47 healthy subjects (group B). The concentration of hydrogen in end-expired alveolar samples was measured after ingestion of 25 g of lactose. Among the 70 subjects, 6 (8.5 p. 100) were not hydrogen producers and were excluded from the study. Lactose malabsorption was shown in 51 of the remaining 64 subjects (79.6 p. 100). Among these 51 patients, 36 were healthy and 15 had an irritable bowel syndrome. The frequency of lactose malabsorption among the 43 healthy hydrogen producers was 83 p. 100. This value is similar to those observed in other studies (greek and italian). Our results suggest that lactose malabsorption is frequent among the tunisian adult population.
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PMID:[Study of malabsorption of lactose by the hydrogen breath test in a population of 70 Tunisian adults]. 365 17

Lactose malabsorption was assessed by the hydrogen breath test in 40 Italian patients with irritable bowel syndrome and 42 controls without abdominal disturbances. Sixty-five percent of patients were "low milk consumers" (0-250 ml milk per day) compared with 38% of controls (P less than 0.02). Lactose loads of 25 and 50 g caused malabsorption in 82.5 and 87.5% patients and in 55 and 62% controls, respectively (patients vs controls P less than 0.02). Malabsorption was more frequent in the "low milk consumers" group (P less than 0.05). During a four-month lactose-free diet as the only treatment 7.5% of patients became symptom-free (and remained so for a further eight-month diet), 52.5% improved, and 40% showed no change.
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PMID:Lactose malabsorption and intolerance in Italians. Clinical implications. 380 34

Sixty consecutive patients suspected of having bacterial overgrowth of the small intestine (BOG) had aerobic and anaerobic bacterial cultures made of fasting upper jejunal fluid and also a 14C-D-xylose breath test (XBT). Culture-proven BOG was present in 23 patients. In another 15 patients the presence of BOG was ruled out (diagnoses: irritable bowel syndrome, 8; chronic diarrhoea, 6; and lactose malabsorption, 1). These patients were used as controls. The other 22 of the 60 patients could not be placed in either group owing to the presence of factors known to predispose for BOG; none of them had abnormal jejunal cultures, but several had strong clinical suspicion of BOG. An abnormal XBT, defined as values exceeding upper 90% confidence limits (upper range) of the 15 patient control values within a 4-h period, was observed with the following frequencies in the 23 patients with BOG: after 60 min, 35%; after 120 min, 44%; after 180 min, 61%; and after 240 min, 65%. An abnormal XBT was observed in 41% of the 22 patients with normal jejunal cultures but with predisposition for, and clinical suspicion of, BOG. It is concluded that, compared with a relevant control material, the XBT tends to be rather insensitive and that a negative outcome of jejunal cultures is inadequate to exclude the presence of BOG.
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PMID:Diagnosis of bacterial overgrowth of the small intestine. Comparison of the 14C-D-xylose breath test and jejunal cultures in 60 patients. 391 62

Lactose malabsorption was studied, by hydrogen breath test, in 72 adults suffering from irritable bowel syndrome, in 20 ulcerative colitis patients, and in 69 healthy subjects. The minimum dose of lactose required to cause a positive breath test was determined, and the symptoms caused and the resulting hydrogen eliminated quantified. A high incidence of lactose malabsorption was shown at standard doses (up to 50 g) in both the healthy subjects (70%) and the patients (86% and 85%, respectively). In the irritable bowel syndrome and the ulcerative colitis groups, symptoms occurred with a smaller quantity of breath hydrogen, presumably in association with a greater individual sensitivity of the colon to distension. The threshold lactose dose was notably lower in the diseased subjects who registered as evidence a prevalence of malabsorption at a 20-g lactose load. The pathogenetic role of lactose malabsorption in the irritable bowel syndrome is emphasized, as is the importance of the personal lactose tolerance.
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PMID:Hydrogen breath test quantification and clinical correlation of lactose malabsorption in adult irritable bowel syndrome and ulcerative colitis. 654 90

77 hospitalized patients with chronic unspecific abdominal complaints, in whom any other organic disease had been previously excluded, were investigated for lactose malabsorption; they were subdivided into two groups: 46 patients complaining primarily of colicky abdominal pain and/or intermittent diarrhoea (group 1) and 31 patients presenting with dyspepsia as the predominant symptom (group 2). To establish the exact prevalence of isolated lactase deficiency in the healthy adult population served by our hospital, 40 Italian adult healthy subjects were also studied. The prevalence of lactose malabsorption was significantly higher (p less than 0.005) in patients of the 1st group than in patients of the 2nd group, and in the healthy adult population seen at our hospital (74% vs 35.5% and 37.5%, respectively). Furthermore a high prevalence of lactose intolerance, determined by means of a three-week diet trial (lactose free-diet versus normal diet), was documented among lactose malabsorbers of the 1st group. We concluded therefore that lactose intolerance is a factor in some Italian adult patients who suffer from long-standing aspecific abdominal discomfort, and it should be always considered in these patients, especially when colicky abdominal pain and diarrhoea are present, before the diagnosis of irritable bowel syndrome is made.
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PMID:Lactose intolerance in adults with chronic unspecific abdominal complaints. 667 46

In adults with the irritable bowel syndrome who had no history of milk intolerance, the prevalence of lactase deficiency and the value of lactose restriction were determined. Eighty subjects with the irritable bowel syndrome who were white, non-Jewish, and of northern-western European background were screened for lactase deficiency by means of the hydrogen breath test. Lactase deficiency was found in 5 of the 80 subjects with the irritable bowel syndrome and in 6 of the 100 subjects without intestinal symptoms who were of comparable ethnic background. After exclusion of milk from the diet, three of the five subjects with lactase deficiency and the irritable bowel syndrome had partial to complete relief of symptoms for 3 weeks, and two of these had sustained relief for 1 year (one with complete and one with 75% improvement). Lactase deficiency was found to be a relatively uncommon cause of irritable bowel symptoms among non-Jewish whites who are of northern-western European background.
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PMID:Irritable bowel syndrome. Role of lactase deficiency. 684 84


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