Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.797
Peer-review started: October 17, 2022
First decision: November 11, 2022
Revised: December 2, 2022
Accepted: January 5, 2023
Article in press: January 5, 2023
Published online: February 6, 2023
Processing time: 112 Days and 3.5 Hours
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.
To examine the efficacy of lactose (cow’s milk) loading treatment in patients with LM.
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.
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. Impro
LM was diagnosed in approximately 75% of the subjects who had LI. Incremental loads of cow’s milk is regarded as a useful treatment for LM without affecting everyday life.
Core Tip: The incidence of lactose malabsorption (LM) is high in East Asians such as Japan. Colonic adaptation by daily consumption of milk or lactose has been known as a method to treat LM, reducing symptoms of lactose intolerance (LI). However, reports regarding such treatment have not been found in Japan. In this study, we clarified the prevalence of LM diagnosed among the Japanese patients who had LI symptoms, and evaluated the efficacy of incremental loads of cow’s milk as a treatment for LM without affecting everyday life.