Lactose malabsorption in Greek.pdf

Gut, 1982, 23, 968-973 Lactose malabsorption in Greek adults: correlation of small bowel transit time with the severity of lactose intolerance* S LADAS,t J PAPANIKOS, and G ARAPAKIS From the Research Unit, Second Propaedeutic Medical Unit of the Athens National University, Evangelismos Hospital, Athens, Greece. SUMMARY Using breath hydrogen analysis after 139 mmol (50 g) oral lactose load, we investigated the prevalence of lactose malabsorption in 200 Greek adults and examined the relationship between symptoms and small bowel transit time. One hundred and fifty subjects had increased breath hydrogen concentrations (20 ppm) after the lactose load. In these individuals peak breath hydrogen concentration was inversely related to small bowel transit time (r= -0*63, t=6.854, p0001) and the severity of symptoms decreased with increasing small bowel transit time. Lactose malabsorbers with diarrhoea during the lactose tolerance test had a small bowel transit time of 51±22 minutes (x±SD; n=90) which was significantly shorter than the small bowel transit time of patients with colicky pain, flatulence, and abdominal distension (74±30, n=53; pO.OOl) and both groups had significantly shorter small bowel transit time than that of asymptomatic malabsorbers (115±21 n:7; p0.001). When the oral lactose load was reduced to 33 mmol (12 g), the small bowel transit time increased five-fold and the overall incidence of diarrhoea and/or symptoms decreased dramatically. These results indicate that the prevalence of lactase deficiency in Greece may be as high as 75% and suggest that symptom production in lactose malabsorbers is brought about by the rapid passage down the small intestine of the malabsorbed lactose. It is well established that the prevalence of inherited delayed onset lactase deficiency ranges widely (2- 100%). Most ethnic groups, however, fall into the categories of either low prevalence (30%), or high prevalence (60%). Only mixed ethnic groups fall into the intermediate rang