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The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption

Background: Dairy products are frequently considered responsible for post-prandial symptoms and are withdrawn from the diet, even against medical advice. We analysed the symptoms patients consider as lactose related; we also evaluated if psychological profile may affect the interpretation of the rel...

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Autores principales: Di Stefano, Michele, Brondino, Natascia, Bonaso, Vera, Miceli, Emanuela, Lapia, Francesco, Grandi, Giacomo, Pagani, Elisabetta, Corazza, Gino Roberto, Di Sabatino, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407992/
https://www.ncbi.nlm.nih.gov/pubmed/36011869
http://dx.doi.org/10.3390/ijerph191610234
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author Di Stefano, Michele
Brondino, Natascia
Bonaso, Vera
Miceli, Emanuela
Lapia, Francesco
Grandi, Giacomo
Pagani, Elisabetta
Corazza, Gino Roberto
Di Sabatino, Antonio
author_facet Di Stefano, Michele
Brondino, Natascia
Bonaso, Vera
Miceli, Emanuela
Lapia, Francesco
Grandi, Giacomo
Pagani, Elisabetta
Corazza, Gino Roberto
Di Sabatino, Antonio
author_sort Di Stefano, Michele
collection PubMed
description Background: Dairy products are frequently considered responsible for post-prandial symptoms and are withdrawn from the diet, even against medical advice. We analysed the symptoms patients consider as lactose related; we also evaluated if psychological profile may affect the interpretation of the relationship between lactose and symptoms. Methods: In 268 patients undergoing lactose breath test, symptoms considered evoked by lactose intake were recorded and their severity measured. In the second part, symptom onset of 40 randomly selected patients was detected after both lactose and glucose breath test were blindly performed. Questionnaires evaluating anxiety, suggestibility and personality trait were administered. Key Results: Symptoms depending on functional gastrointestinal disorders or reflux disease were frequent in self-reported lactose-intolerant patients. In comparison with lactose malabsorption, these symptoms proved to be more frequent in patients with negative lactose breath test. The blinded administration of lactose and glucose demonstrated that a correct link between lactose intake and symptom onset was possible, only in 47.5% of the subjects, making this test inaccurate. None of the investigated psychological characteristics were different between patients with a nocebo response and patients not experiencing nocebo. Conclusions: Patients with self-reported lactose intolerance are frequently unaware about clinical presentation of this condition, and correct information is needed. The detection of symptom onset after lactose is an inaccurate test for lactose intolerance. Furthermore, the analysis of psychological characteristics of patients undergoing hydrogen breath test is not useful to select the subgroup at risk for a nocebo response. New strategies to diagnose lactose intolerance are mandatory.
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spelling pubmed-94079922022-08-26 The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption Di Stefano, Michele Brondino, Natascia Bonaso, Vera Miceli, Emanuela Lapia, Francesco Grandi, Giacomo Pagani, Elisabetta Corazza, Gino Roberto Di Sabatino, Antonio Int J Environ Res Public Health Article Background: Dairy products are frequently considered responsible for post-prandial symptoms and are withdrawn from the diet, even against medical advice. We analysed the symptoms patients consider as lactose related; we also evaluated if psychological profile may affect the interpretation of the relationship between lactose and symptoms. Methods: In 268 patients undergoing lactose breath test, symptoms considered evoked by lactose intake were recorded and their severity measured. In the second part, symptom onset of 40 randomly selected patients was detected after both lactose and glucose breath test were blindly performed. Questionnaires evaluating anxiety, suggestibility and personality trait were administered. Key Results: Symptoms depending on functional gastrointestinal disorders or reflux disease were frequent in self-reported lactose-intolerant patients. In comparison with lactose malabsorption, these symptoms proved to be more frequent in patients with negative lactose breath test. The blinded administration of lactose and glucose demonstrated that a correct link between lactose intake and symptom onset was possible, only in 47.5% of the subjects, making this test inaccurate. None of the investigated psychological characteristics were different between patients with a nocebo response and patients not experiencing nocebo. Conclusions: Patients with self-reported lactose intolerance are frequently unaware about clinical presentation of this condition, and correct information is needed. The detection of symptom onset after lactose is an inaccurate test for lactose intolerance. Furthermore, the analysis of psychological characteristics of patients undergoing hydrogen breath test is not useful to select the subgroup at risk for a nocebo response. New strategies to diagnose lactose intolerance are mandatory. MDPI 2022-08-17 /pmc/articles/PMC9407992/ /pubmed/36011869 http://dx.doi.org/10.3390/ijerph191610234 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Di Stefano, Michele
Brondino, Natascia
Bonaso, Vera
Miceli, Emanuela
Lapia, Francesco
Grandi, Giacomo
Pagani, Elisabetta
Corazza, Gino Roberto
Di Sabatino, Antonio
The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption
title The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption
title_full The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption
title_fullStr The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption
title_full_unstemmed The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption
title_short The Perception of Lactose-Related Symptoms of Patients with Lactose Malabsorption
title_sort perception of lactose-related symptoms of patients with lactose malabsorption
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407992/
https://www.ncbi.nlm.nih.gov/pubmed/36011869
http://dx.doi.org/10.3390/ijerph191610234
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