1.Lactose Sensitivity and Lactose Malabsorption:The 2 Faces of Lactose Intolerance
Michel BOUCHOUCHA ; Marinos FYSEKIDIS ; Pierre ROMPTEAUX ; Jean-Jacques RAYNAUD ; Jean-Marc SABATE ; Robert BENAMOUZIG
Journal of Neurogastroenterology and Motility 2021;27(2):257-264
Background/Aims:
Self-reported lactose intolerance (LI) is frequent in patients with functional bowel disorders (FBD) that could be interpreted as irritable bowel syndrome (IBS). The present study aims to characterize the responses of patients with FBD, without small intestinal bacterial overgrowth (SIBO), and LI, in terms of lactose malabsorption (LM) and lactose sensitivity (LS) according to psychological and clinical features.
Methods:
One hundred and fifty-eight consecutive FBD outpatients with LI, and no SIBO, were classified according to the Rome III questionnaire and filled Beck Depression Inventory, and State and Trait Anxiety questionnaires. They underwent a lactose tolerance test in which glycemia during 60 minutes and digestive symptoms for 3 hours were recorded.
Results:
Abnormal lactose tolerance tests were found in 110 patients (70%), 44 (28%) with LM, 96 (61%) with LS, and 30 (19%) having both LM and LS. LM patients had a higher frequency of functional diarrhea (P = 0.040) and a lower frequency of dysphagia (P = 0.031).LS patients had a higher depression score (P = 0.007), higher frequency of globus (P = 0.042), irritable bowel syndrome (IBS) (P = 0.027) and mixed IBS (P = 0.049), and lower frequency of abdominal pain (P = 0.040). LS was significantly associated with a higher depression score (P = 0.002), and a higher frequency of globus (P = 0.046).
Conclusions
Thirty percent of LI patients have normal lactose absorption and normal LS. In the other 70% of patients, LI could be associated with LM and/or LS.
2.Lactose Sensitivity and Lactose Malabsorption:The 2 Faces of Lactose Intolerance
Michel BOUCHOUCHA ; Marinos FYSEKIDIS ; Pierre ROMPTEAUX ; Jean-Jacques RAYNAUD ; Jean-Marc SABATE ; Robert BENAMOUZIG
Journal of Neurogastroenterology and Motility 2021;27(2):257-264
Background/Aims:
Self-reported lactose intolerance (LI) is frequent in patients with functional bowel disorders (FBD) that could be interpreted as irritable bowel syndrome (IBS). The present study aims to characterize the responses of patients with FBD, without small intestinal bacterial overgrowth (SIBO), and LI, in terms of lactose malabsorption (LM) and lactose sensitivity (LS) according to psychological and clinical features.
Methods:
One hundred and fifty-eight consecutive FBD outpatients with LI, and no SIBO, were classified according to the Rome III questionnaire and filled Beck Depression Inventory, and State and Trait Anxiety questionnaires. They underwent a lactose tolerance test in which glycemia during 60 minutes and digestive symptoms for 3 hours were recorded.
Results:
Abnormal lactose tolerance tests were found in 110 patients (70%), 44 (28%) with LM, 96 (61%) with LS, and 30 (19%) having both LM and LS. LM patients had a higher frequency of functional diarrhea (P = 0.040) and a lower frequency of dysphagia (P = 0.031).LS patients had a higher depression score (P = 0.007), higher frequency of globus (P = 0.042), irritable bowel syndrome (IBS) (P = 0.027) and mixed IBS (P = 0.049), and lower frequency of abdominal pain (P = 0.040). LS was significantly associated with a higher depression score (P = 0.002), and a higher frequency of globus (P = 0.046).
Conclusions
Thirty percent of LI patients have normal lactose absorption and normal LS. In the other 70% of patients, LI could be associated with LM and/or LS.
3.Perceived Gastrointestinal Symptoms and Association With Meals in a French Cohort of Patients With Irritable Bowel Syndrome
Chloé MELCHIOR ; Simon FREMAUX ; Pauline JOUËT ; Gilles MACAIGNE ; Jean-Jacques RAYNAUD ; Suzelle FACON ; Franck IGLICKI ; Yannick TAES ; Jean-Marc SABATE
Journal of Neurogastroenterology and Motility 2021;27(4):574-580
Background/Aims:
The aim of our study is to evaluate the association between meals and perceived gastrointestinal symptoms in real life in a French cohort of irritable bowel syndrome (IBS) patients.
Methods:
This prospective cross-sectional observational study included patients from the French association (association des patients souffrant du syndrome de l’intestin irritable [APSSII]) of IBS. Data were collected on demographics, IBS subtype, dietary food, and meal-induced gastrointestinal symptoms from patient filled self-questionnaires or questionnaires.
Results:
Eighty-four patients with IBS were included; 82.3% female with a mean age of 46.9 ± 15.7 years. Each transit pattern subtype represented one-third of the population. Forty-five percent of patients had severe IBS according to IBS-Severity Scoring System; mean IBS Quality of Life score was 53.9 ± 18.3. Patients believed that food could trigger or exacerbate gastrointestinal symptoms in 73.3% and 93.4%, respectively. Eighty-nine percent had already tried diets, mostly lactose free diet and low fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols diet in 61.3% and 53.6% of cases. Thirty-nine percent of meals induced gastrointestinal symptoms. Meal-induced gastrointestinal symptoms were associated with severity and subtype but not with quality of life.
Conclusions
This study has confirmed the important link between gastrointestinal symptoms and food. Gastrointestinal symptoms induced by meals are frequent and associated with severity and IBS-diarrhea subtype. Our study also underlines patients’ interest in food and diet.More knowledge is needed on food that triggers IBS symptoms but also on diet conditions in order to improve this condition.
4.Perceived Gastrointestinal Symptoms and Association With Meals in a French Cohort of Patients With Irritable Bowel Syndrome
Chloé MELCHIOR ; Simon FREMAUX ; Pauline JOUËT ; Gilles MACAIGNE ; Jean-Jacques RAYNAUD ; Suzelle FACON ; Franck IGLICKI ; Yannick TAES ; Jean-Marc SABATE
Journal of Neurogastroenterology and Motility 2021;27(4):574-580
Background/Aims:
The aim of our study is to evaluate the association between meals and perceived gastrointestinal symptoms in real life in a French cohort of irritable bowel syndrome (IBS) patients.
Methods:
This prospective cross-sectional observational study included patients from the French association (association des patients souffrant du syndrome de l’intestin irritable [APSSII]) of IBS. Data were collected on demographics, IBS subtype, dietary food, and meal-induced gastrointestinal symptoms from patient filled self-questionnaires or questionnaires.
Results:
Eighty-four patients with IBS were included; 82.3% female with a mean age of 46.9 ± 15.7 years. Each transit pattern subtype represented one-third of the population. Forty-five percent of patients had severe IBS according to IBS-Severity Scoring System; mean IBS Quality of Life score was 53.9 ± 18.3. Patients believed that food could trigger or exacerbate gastrointestinal symptoms in 73.3% and 93.4%, respectively. Eighty-nine percent had already tried diets, mostly lactose free diet and low fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols diet in 61.3% and 53.6% of cases. Thirty-nine percent of meals induced gastrointestinal symptoms. Meal-induced gastrointestinal symptoms were associated with severity and subtype but not with quality of life.
Conclusions
This study has confirmed the important link between gastrointestinal symptoms and food. Gastrointestinal symptoms induced by meals are frequent and associated with severity and IBS-diarrhea subtype. Our study also underlines patients’ interest in food and diet.More knowledge is needed on food that triggers IBS symptoms but also on diet conditions in order to improve this condition.