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• W3140772666 abstract "Background. Ingestion of a large dose of the milk sugar lactose — for example, the 50-g load in 1 liter of milk — causes symptoms such as abdominal pain, di- arrhea, bloating, and flatulence in the majority of people with lactose malabsorption. It is uncertain whether the in- gestion of more common doses of lactose, such as the amount in 240 ml (8 oz) of milk, causes symptoms. Some people insist that even smaller quantities of milk, such as the amount used with cereal or coffee, cause severe gas- trointestinal distress. Methods. In a randomized, double-blind, crossover trial, we evaluated gastrointestinal symptoms in 30 peo- ple (mean age, 29.4 years; range, 18 to 50) who report- ed severe lactose intolerance and said they consistently had symptoms after ingesting less than 240 ml of milk. The ability to digest lactose was assessed by measuring the subjects' end-alveolar hydrogen concentration after they ingested 15 g of lactose in 250 ml of water. Sub- jects then received either 240 ml of lactose-hydrolyzed milk containing 2 percent fat or 240 ml of milk containing 2 percent fat and sweetened with aspartame to approx- imate the taste of lactose-hydrolyzed milk; each type of milk was administered daily with breakfast for a one-week period. Using a standardized scale, subjects rated the occurrence and severity of bloating, abdominal pain, diarrhea, and flatus and recorded each passage of flatus. Results. Twenty-one participants were classified as having lactose malabsorption and nine as being able to absorb lactose. During the study periods, gastrointestinal symptoms were minimal (mean symptom-severity scores for bloating, abdominal pain, diarrhea, and flatus between 0.1 and 1.2 (1 indicated trivial symptoms; and 2, mild symptoms)). When the periods were compared, there were no statistically significant differences in the severity of these four gastrointestinal symptoms. For the lactose- malabsorption group, the mean ( � SEM) difference in ep- isodes of flatus per day was 2.5 � 1.1 (95 percent confi- dence interval, 0.2 to 4.8). Daily dietary records indicated a high degree of compliance, with no additional sources of lactose reported. Conclusions. People who identify themselves as se- verely lactose-intolerant may mistakenly attribute a vari- ety of abdominal symptoms to lactose intolerance. When lactose intake is limited to the equivalent of 240 ml of milk or less a day, symptoms are likely to be negligible and the use of lactose-digestive aids unnecessary. (N Engl J Med 1995;333:1-4.)" @default.
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• W3140772666 date "1995-01-01" @default.
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• W3140772666 title "A COMPARISON OF SYMPTOMS AFTER THE CONSUMPTION OF MILK OR LACTOSE- HYDROLYZED MILK BY PEOPLE WITH SELF-REPORTED SEVERE LACTOSE INTOLERANCE" @default.
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