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Aliment Pharmacol Ther. 2008 Apr;27(8):659-65. doi: 10.1111/j.1365-2036.2008.03623.x. Epub 2008 Jan 22.

Correlation between symptoms developed after the oral ingestion of 50 g lactose and results of hydrogen breath testing for lactose intolerance.

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1
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland.

Abstract

BACKGROUND:

Lactase deficiency is a common condition responsible for various abdominal symptoms. Lactose hydrogen breath test is currently the gold standard in diagnosing lactose intolerance.

AIM:

To assess sensitivity and specificity of symptoms developed after oral lactose challenge.

METHODS:

Intensity of nausea, abdominal pain, borborygmi, bloating and diarrhoea was recorded every 15 min up to 3 h after ingestion of 50 g lactose in patients with positive (i.e. breath H2-concentration > or =20 p.p.m. above baseline) and negative lactose hydrogen breath test.

RESULTS:

Between July 1999 and December 2005, 1127 patients (72% females) underwent lactose hydrogen breath test. A positive result was found in 376 (33%). Sensitivity of individual symptoms ranged from 39% (diarrhoea) to 70% (bloating) while specificity ranged from 69% (bloating) to 90% (diarrhoea). A positive lactose hydrogen breath test was found in 21% of patients with one symptom, 40% of patients with two symptoms, 44% of patients with three symptoms, 67% of patients with four symptoms and 82% of patients with five symptoms. Symptom intensity was significantly higher for each symptom in the positive group.

CONCLUSION:

Evaluating symptoms developed after ingestion of 50 g lactose can be used as a simple screening test to select patients who need to be referred for lactose intolerance testing.

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