Lactose Malabsorption and Presumed Related Disorders: A Review of Current Evidence.
Study Goal
The researchers aimed to clarify the clinical impact of lactose malabsorption (LM) on digestive and extra-digestive disorders, including its role in persistent symptoms in celiac disease (CD) on a gluten-free diet.
Results Summary
The study found that LM can contribute to persistent symptoms in CD and inflammatory bowel diseases (IBD) despite a gluten-free diet, while its association with irritable bowel syndrome (IBS) appears coincidental. A lactose-restricted diet may benefit some IBS patients, and LM can affect bone mass and levothyroxine absorption.
Population
Individuals with celiac disease, inflammatory bowel diseases, irritable bowel syndrome, and lactose malabsorption.
Effective Dosage
Not specified
Duration
Not specified
Interactions
Levothyroxine absorption may be affected by lactose malabsorption.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
lactose-restricted diet | decrease | symptoms | some IBS patients | - | may be useful | #1 |
reduced lactose intake | decrease | bone mass | - | low | can lead to | #2 |
reduced lactose intake | decrease | risk of fragility fractures | - | limited | can lead to | #3 |
lactose malabsorption | increase | persistent symptoms | celiac disease patients on a gluten-free diet | - | can be responsible for | #4 |
lactose malabsorption | increase | persistent symptoms | inflammatory bowel disease patients on clinical remission | - | can be responsible for | #5 |
lactose malabsorption | decrease | bone mass | - | - | can affect | #6 |
lactose malabsorption | decrease | absorption of levothyroxine | - | - | can condition | #7 |
BACKGROUND: Lactose malabsorption (LM) is a frequent clinical problem associated with several digestive and extra-digestive diseases. The aim of this manuscript was to clarify the real clinical impact of LM on these disorders. METHODS: A literature search for digestive and extra-digestive disorders related to LM was carried out using PubMed, Medline and Cochrane. RESULTS: A transient lactase deficiency is present in celiac disease (CD) on a normal diet. The persistence of symptoms in CD on a gluten-free diet may be instead, in part, attributed to a primary LM. Similar circumstances are present in inflammatory bowel diseases (IBD), in which LM can be responsible for a part of persistent symptoms in IBD on clinical remission. LM and irritable bowel syndrome (IBS) are instead independent conditions. On the other hand, a lactose-restricted diet may be useful for some IBS patients. A reduced lactose intake can lead to low bone mass and limited risk of fragility fractures. Finally, the absorption of levothyroxine could be conditioned by LM. CONCLUSIONS: LM can be responsible for persistent symptoms in CD and IBD. The association with IBS seems to be casual. Bone mass and levothyroxine absorption can be affected by LM.