Efficacy of incremental loads of cow's milk as a treatment for lactose malabsorption in Japan  

作　　者：Matsuri Hasegawa Kazuko Okada Satoru Nagata Shigetaka Sugihara 

机构地区：[1]Department of Pediatrics,Tokyo Women's Medical University Medical Center East,Department of Pediatrics,Tokyo Women’s Medical University Medical Center East,Arakawa-ku 116-8561,Tokyo,Japan [2]Department of Pediatrics,Okada Pediatric Clinic,Shinjuku-ku 169-0072,Tokyo,Japan [3]Department of Pediatrics,Tokyo Women’s Medical University,Shinjuku-ku 162-8666,Tokyo,Japan

出　　处：《World Journal of Clinical Cases》2023年第4期797-808,共12页世界临床病例杂志

基　　金：Supported by Grants of J-milk(Japan Dairy Association)。

摘　　要：BACKGROUND Lactose intolerance(LI)is commonly seen in East Asian countries.Several studies showed that lactose or milk loading has been used as a treatment for lactose malabsorption(LM)in Western countries,but there have been no reports regarding this type of treatment in Japan.As lactose or milk loading requires ingestion of large amounts of lactose within a short period,this is considered to be too harsh for Japanese people because of their less habitual milk consumption(175 mL per day in average)than Western people.In this study,we demonstrated lactose tolerance acquisition in a suitable way for Japanese.AIM To examine the efficacy of lactose(cow’s milk)loading treatment in patients with LM.METHODS Individuals with abdominal symptoms induced by milk or dairy products(LI symptoms)were identified with a questionnaire.A 20 g lactose hydrogen breath test(LHBT)was carried out to confirm LM diagnosis and to evaluate co-existence of small intestinal bacterial overgrowth(SIBO).Respondents diagnosed with LM were selected as study subjects and were treated with incremental loads of cow’s milk,starting from 30 mL and increasing up to 200 mL at 4-7 d intervals.After the treatment,changes in symptoms and LM diagnostic value of 20 g LHBT were investigated.Stool samples pre-and post-treatment were examined for changes in intestinal microbiota using 16S rRNA sequencing.Informed consent was obtained prior to each stage of the study.RESULTS In 46 subjects with LI symptoms(10-68 years old,mean age 34 years old)identified with the questionnaire,35(76.1%)were diagnosed with LM by 20 g LHBT,and 6 had co-existing SIBO.The treatment with incremental cow’s milk was carried out in 32 subjects diagnosed with LM(14-68 years old,median age 38.5 years old).The mean period of the treatment was 41±8.6 d.Improvement of symptoms was observed in 29(90.6%;95%confidence interval:75.0%-98.0%)subjects.Although 20 g LHBT indicated that 10(34.5%)subjects had improved diagnostic value of LM,no change was observed in 16(55.2%)subjects.Analysis o

关 键 词：Lactose Intolerance Lactose Malabsorption lactose loading treatment Intestinal bacterial flora Fecal microbiota 

分 类 号：R723.1[医药卫生—儿科]