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

Michele Di Stefano (), Natascia Brondino, Vera Bonaso, Emanuela Miceli, Francesco Lapia, Giacomo Grandi, Elisabetta Pagani, Gino Roberto Corazza and Antonio Di Sabatino
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Michele Di Stefano: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy
Natascia Brondino: Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
Vera Bonaso: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy
Emanuela Miceli: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy
Francesco Lapia: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy
Giacomo Grandi: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy
Elisabetta Pagani: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy
Gino Roberto Corazza: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy
Antonio Di Sabatino: Department of Internal Medicine, IRCCS “S. Matteo” Hospital Foundation, University of Pavia, 27100 Pavia, Italy

IJERPH, 2022, vol. 19, issue 16, 1-13

Abstract: Background: Dairy products are frequently considered responsible for post-prandial symptoms and are withdrawn from the diet, even against medical advice.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.

Keywords: lactose; lactose intolerance; nocebo effect; self-reported symptom (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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