Low-dose lactose in drugs neither increases breath hydrogen.pdf

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Low-dose lactose in drugs neither increases breath hydrogen.pdf

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Low-dose lactose in drugs neither increases breath hydrogen

Low-dose lactose in drugs neither increases breath hydrogen excretion nor causes gastrointestinal symptoms M. MONTALTO, A. GALLO, L . SANTORO, F . D’ONOFRIO, V. CURIGLIANO, M. COVINO, G. CAMMAROTA, A. GRIECO, A. GASBARRINI G. GASBARRINI Institute of Internal Medicine, Catholic University, Rome, Italy Correspondence to: Dr M. Montalto, Istituto di Medicina Interna, Policlinico ‘‘A. Gemelli’’, Universita? Cattolica del Sacro Cuore, Largo A. Gemelli, 8 – 00168 Roma, Italia. E-mail: mmontalto@rm.unicatt.it Publication data Submitted 16 May 2008 First decision 30 May 2008 Resubmitted 14 July 2008 Resubmitted 21 July 2008 Accepted 22 July 2008 Epub Accepted Article 24 July 2008 SUMMARY Background Despite the reported tolerance to a low dose of lactose, many lactose malabsorbers follow a rigorous lactose-free diet also avoiding lactose- containing drugs. Up to now, only a few case reports have described the onset of gastrointestinal symptoms in lactose malabsorbers follow- ing the ingestion of these drugs. It has been suggested that capsules ? tablets contain no more than 400 mg of lactose. Aim To evaluate breath H2 excretion and intolerance symptoms after inges- tion of a capsule containing 400 mg of lactose or placebo through a randomized, cross-over, double-blind, controlled study. Methods Seventy-seven lactose maldigesters with intolerance underwent two H2 breath tests with both 400 mg of lactose and 400 mg of placebo. Gastro- intestinal symptoms occurring in the 8 h following the ingestion of dif- ferent substrates were evaluated by a visual-analogue scale. Results Ingestion of 400 mg of lactose did not cause a significant difference in breath H2 excretion or in the severity of gastrointestinal symptoms compared to placebo. Conclusion In patients with lactase deficiency, drugs containing 400 mg of lactose or less can be used safely. Aliment Pharmacol Ther 28, 1003–1012 Alimentary Pharmacology Therapeutics a 2008 The Authors 1003 Journal compilation a 2008 Blackwell