Materiały źródłowe

• #1 Lactose Intolerance – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532285/

  Lactose intolerance is a clinical syndrome that manifests with characteristic signs and symptoms upon consuming food substances containing lactose, a disaccharide. […] Deficiency of lactase due to primary or secondary causes results in clinical symptoms. […] Lactose intolerance presents with abdominal bloating and pain, loose stools, nausea, flatulence, and borborygmi. […] Lactose intolerance is evaluated by getting a careful history, performing a physical exam, and medical tests. […] It is essential to take a past medical, family, and dietary history to determine the cause of lactose intolerance and exclude secondary causes. […] The diagnosis and management of lactose intolerance are with an interprofessional team that includes a nurse practitioner, primary care provider, pediatrician, gastroenterologist, and an allergist.

• #2 Lactose Intolerance: What Your Breath Can Tell You

  https://www.mdpi.com/2075-4418/10/6/412

  Lactose intolerance has seen recognized as a clinical syndrome characterized by pain, abdominal distention, flatulence, and diarrhea after the consumption of lactose. […] Currently, there are several diagnostic tests that investigate the biological mechanism of lactose intolerance such as blood, biopsy, genetic, and breath tests. […] Due to its relatively low cost, availability, and non-invasiveness, the hydrogen breath test (HBT) has become a popular technology to aid in the diagnosis of many gastroenterological diseases, specifically lactose intolerance. […] With all the diagnostic techniques available for the testing of lactose intolerance, there seems to be a lack of uniform criteria that each procedure follows. […] Currently, there are four methods that are available in the diagnosis of lactose malabsorption and lactose intolerance.

• #3 Lactose intolerance | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/lactose-intolerance/

  Diagnosing lactose intolerance is important as the symptoms can be similar to other conditions. […] Your GP may suggest trying to remove lactose from your diet for two weeks to see if it helps to relieve your symptoms. This will provide further evidence of whether you’re lactose intolerant. […] It’s important to visit your GP if you think you or your child may have lactose intolerance, as the symptoms can be similar to other conditions. […] Your GP may suggest further tests to help confirm the diagnosis, find out how much lactase your body is producing, or try to determine what might be causing your lactose intolerance. […] A hydrogen breath test is a simple way of determining if you may be lactose intolerant. […] If your breath contains a large amount of hydrogen after consuming the lactose solution, it’s likely that you’re lactose intolerant.

• #4 Diagnosis of Lactose Intolerance – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/diagnosis

  To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. […] Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. […] Your doctor may ask you to stop eating and drinking milk and milk products for a period of time to see if your symptoms go away. If your symptoms dont go away, your doctor may order additional tests. […] Your doctor may order a hydrogen breath test to see how well your small intestine digests lactose. […] Doctors use this test to diagnose lactose malabsorption and lactose intolerance. […] If both your breath hydrogen levels rise and your symptoms get worse during the test, your doctor may diagnose lactose intolerance.

• #5 Lactose intolerance – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lactose-intolerance/diagnosis-treatment/drc-20374238

  Your doctor might suspect lactose intolerance based on your symptoms and your response to reducing the amount of dairy foods in your diet. Your doctor can confirm the diagnosis by conducting one or more of the following tests: […] Hydrogen breath test. After you drink a liquid that contains high levels of lactose, your doctor measures the amount of hydrogen in your breath at regular intervals. Breathing out too much hydrogen indicates that you aren’t fully digesting and absorbing lactose. […] Lactose tolerance test. Two hours after drinking a liquid that contains high levels of lactose, you’ll undergo blood tests to measure the amount of glucose in your bloodstream. If your glucose level doesn’t rise, it means your body isn’t properly digesting and absorbing the lactose-filled drink. […] Keep track of your daily servings of dairy foods, including milk, ice cream, yogurt and cottage cheese, and when you have them and what you eat with them. Also let your doctor know which dairy foods, in what amounts, give you symptoms. This information can help your doctor make a diagnosis. […] If you think you may have lactose intolerance, try cutting dairy products from your diet for a few days to see if your symptoms ease. Let your doctor know if your symptoms got better on the days you didn’t have dairy products.

• #6 Lactose intolerance: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/180120

  If a person suspects that they are lactose intolerant, they can keep a food diary that lists the foods they eat and any symptoms that arise. This can help them and their physician work out which foods are causing the symptoms. […] Most healthcare providers recommend that people try a lactose free diet for a period to see if symptoms improve. […] Some tests can detect a lactose intolerance. They are: […] Hydrogen breath test: The person fasts overnight and then takes a lactose solution the following morning. A physician then measures the levels of hydrogen in exhaled air. High levels of hydrogen indicate lactose intolerance. […] Lactose tolerance test: The person consumes a lactose solution, and a physician takes blood samples to measure their glucose levels. If blood glucose levels remain the same, the body has not broken down the lactose properly.

• #7 Lactose Intolerance – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532285/

  Lactose intolerance is a clinical syndrome that manifests with characteristic signs and symptoms upon consuming food substances containing lactose, a disaccharide. […] Deficiency of lactase due to primary or secondary causes results in clinical symptoms. […] Lactose intolerance presents with abdominal bloating and pain, loose stools, nausea, flatulence, and borborygmi. […] Lactose intolerance is evaluated by getting a careful history, performing a physical exam, and medical tests. […] It is essential to take a past medical, family, and dietary history to determine the cause of lactose intolerance and exclude secondary causes. […] The diagnosis and management of lactose intolerance are with an interprofessional team that includes a nurse practitioner, primary care provider, pediatrician, gastroenterologist, and an allergist.

• #8

  https://bpac.org.nz/2021/lactose-intolerance.aspx

  Primary lactase deficiency, the main cause of lactose intolerance, is estimated to affect 8% of people in New Zealand, with substantially higher rates among Mori, Pacific and southeast Asian peoples. […] Lactose intolerance can usually be diagnosed through dietary challenge, i.e. the return of symptoms following reintroduction of milk and milk products after an elimination period. […] Lactose intolerance is initially treated by minimising or avoiding lactose-containing foods, however, most people can eventually tolerate one to two glasses of milk daily, if consumed in small portions with food. […] A lactose-free diet should be trialled for two to four weeks when lactose intolerance is suspected. […] If symptoms improve during the two to four week period and return when lactose is reintroduced, the diagnosis can be made.

• #9 Lactose intolerance | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/lactose-intolerance/

  Diagnosing lactose intolerance is important as the symptoms can be similar to other conditions. […] Your GP may suggest trying to remove lactose from your diet for two weeks to see if it helps to relieve your symptoms. This will provide further evidence of whether you’re lactose intolerant. […] It’s important to visit your GP if you think you or your child may have lactose intolerance, as the symptoms can be similar to other conditions. […] Your GP may suggest further tests to help confirm the diagnosis, find out how much lactase your body is producing, or try to determine what might be causing your lactose intolerance. […] A hydrogen breath test is a simple way of determining if you may be lactose intolerant. […] If your breath contains a large amount of hydrogen after consuming the lactose solution, it’s likely that you’re lactose intolerant.

• #10

  https://bpac.org.nz/2021/lactose-intolerance.aspx

  Lactose intolerance can be suspected in people who report gastrointestinal symptoms following the ingestion of milk or milk products. […] If dietary challenge is inconclusive or self-reported symptoms are unreliable, further investigations may be required. […] Although laboratory testing is often cited in literature to aid in the diagnosis of lactose intolerance, most of these tests are not widely accessible in New Zealand or not publicly funded, and some lack sensitivity and/or specificity. […] Lactose intolerance is usually diagnosed by dietary challenge. […] Do not routinely request skin prick or serum allergen-specific IgE tests as lactose intolerance is not immune mediated. […] Lactose usually does not need to be excluded from the diet; people should start with a more restricted diet and gradually increase the consumption of lactose-containing foods according to individual tolerance level. […] A temporary lactose-free diet may be beneficial for people with secondary lactose intolerance, e.g. following a bout of infectious diarrhoea, to promote recovery from the primary illness.

• #11 Lactose intolerance: Diagnosis and diet strategies

  https://www.contemporarypediatrics.com/view/lactose-intolerance-diagnosis-and-diet-strategies

  Diarrhea, abdominal pain, and flatulence following ingestion of milk or products containing milk are common complaints in pediatric practices. The pediatrician needs to be aware of the management of lactose intolerance to help guide a reasonable workup and plan. […] Pediatricians take a varied approach to the diagnosis of lactose intolerance. Many pediatricians make a presumptive diagnosis based on history alone with the presence of symptoms with ingestion of lactose products. The diagnosis is often buttressed by symptom resolutions with avoidance and recurrence upon lactose challenge. The 2006 guideline from the American Academy of Pediatrics (AAP) states that a strict lactose-free, 2-week trial with resolution of symptoms and recurrence upon reintroduction is sufficient for diagnosis. […] This is a simple, noninvasive test wherein the patient receives a lactose load and the breath is measured for hydrogen every 15 to 30 minutes for up to 3 hours. The test looks for increased levels of hydrogen, which normally peaks in 90 to 120 minutes following the load. At 78% and 98%, respectively, the sensitivity and specificity are superior to the absorption test. It is considered the most reliable and cost-effective test for diagnosing lactose malabsorption.

• #12 Lactose Intolerance: What Your Breath Can Tell You

  https://www.mdpi.com/2075-4418/10/6/412

  Lactose intolerance has seen recognized as a clinical syndrome characterized by pain, abdominal distention, flatulence, and diarrhea after the consumption of lactose. […] Currently, there are several diagnostic tests that investigate the biological mechanism of lactose intolerance such as blood, biopsy, genetic, and breath tests. […] Due to its relatively low cost, availability, and non-invasiveness, the hydrogen breath test (HBT) has become a popular technology to aid in the diagnosis of many gastroenterological diseases, specifically lactose intolerance. […] With all the diagnostic techniques available for the testing of lactose intolerance, there seems to be a lack of uniform criteria that each procedure follows. […] Currently, there are four methods that are available in the diagnosis of lactose malabsorption and lactose intolerance.

• #13

  https://link.springer.com/article/10.1007/s42399-021-00792-9

  Lactose intolerance is a pathology frequently encountered today. It occurs when the activity of lactase in the intestine is reduced or absent, with consequent failure to digest lactose. The global prevalence of this clinical condition is estimated of about 57% with instrumental methods, while the real prevalence exceeds 65%. […] Therefore, it is essential to diagnose and properly treat this pathology. Various options exist for diagnosing lactose intolerance: Hydrogen Breath Test, genetic test, Quick Lactose Intolerant Test, Lactose Tolerance Test, Gaxilose Test. […] The formal test which is commonly used in patients suspected of having lactose intolerance is the H2 Breath Test (HBT). It has become widely available and it is often used for diagnosis of lactose intolerance. The test is based on the principle that undigested lactose undergoes fermentation by the microbial flora, with subsequent gas production, including hydrogen.

• #14 Lactose Tolerance Tests: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/lactose-tolerance-tests/

  Lactose tolerance tests measure your body’s ability to break down lactose. […] Getting the symptoms of lactose malabsorption after you eat or drink products with lactose is called lactose intolerance. […] Lactose tolerance tests are used to: Diagnose lactose intolerance. […] You may need this test if you have symptoms of lactose intolerance. […] If you are diagnosed with lactose intolerance, you should be able to manage your condition by limiting or avoiding foods with lactose, such as milk and cheese. […] Lactose intolerance is not the same as an allergy to milk or dairy. An allergy is an immune system response and can cause severe symptoms. While lactose intolerance does not cause serious complications, it can lead to uncomfortable and unpleasant symptoms. Adjusting your diet may help you avoid this discomfort.

• #15 Lactose Intolerance – Cause, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/digestive-disorders/digestive-diseases-lactose-intolerance

  Millions of Americans cant digest a certain sugar in milk and milk products called lactose. If youre one of them, you have lactose intolerance. […] Your doctor can test for lactose intolerance: […] Breath test. This will show if you have high levels of hydrogen when you exhale. If you do, you might be lactose intolerant. […] Blood test. This can show how your body reacts after you drink something with a lot of lactose. […] Stool acidity test. This is the test used for children and infants. […] Genetic test. Using a sample of your blood or spit, a lab checks to see if your genes could be behind your lactose intolerance. […] Surgical biopsy. This is done in a hospital under anesthesia. The surgeon makes a cut in your stomach and takes a sample of your small intestine tissue. A lab then checks the sample for signs of lactose intolerance.

• #16 How to test for lactose intolerance

  https://blog.walgreens.com/health/digestive-health/how-to-test-for-lactose-intolerance.html

  Lactose intolerance is a common ailment that involves the inability to break down and digest lactose, a type of sugar typically found in milk and other dairy products. There are several ways to test for the condition. […] Yes, there are several methods of testing for lactose intolerance. These tests may be performed partly at home or in a clinical setting. […] The most common lactose intolerance test is called the hydrogen breath test. This test will be ordered by your healthcare provider. […] The hydrogen breath test measures how much hydrogen gas is in your breath. Normally, very little hydrogen gas is found in the air we exhale, but if your body has difficulty breaking down lactose, those levels will rise. Test results showing an abnormally high level of hydrogen gas in your breath samples may suggest that you may have lactose intolerance.

• #17 How does the Diagnosis of lactose intolerance – nmi-Portal – Ernährung im Fokus% work?

  https://www.nahrungsmittel-intoleranz.com/en/diagnosis-of-lactose-intolerance/

  Lactose intolerance refers exclusively to the intolerance of the milk sugar lactose. However, it does not identify the exact cause of this intolerance. However, as the causes are crucial for successful treatment, medical clarification is essential. But how does the diagnosis of lactose intolerance work? What diagnostic methods are there and are they reliable? We have summarized all this for you in this article. […] If lactose intolerance is suspected, it is advisable first of all to keep a food and symptom diary first of all. This helps the doctor treating you to better classify the symptoms and make a specific diagnosis. […] The H2 breath test is considered the best diagnostic method and the current gold standard for detecting lactose intolerance. […] After taking the test solution, you blow into a breath meter at regular intervals, usually every 30 minutes, which measures the hydrogen content in the air you breathe.

• #18 Lactose tolerance tests: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/003500.htm

  Lactose tolerance tests measure the ability of your intestines to break down a type of sugar called lactose. This sugar is found in milk and other dairy products. If your body cannot break down this sugar, you are said to have lactose intolerance. This can cause gassiness, abdominal pain, cramps, and diarrhea. […] Your health care provider may order these tests if you have signs of lactose intolerance. […] Abnormal results may be a sign of lactose intolerance. […] A breath test result that shows a rise in hydrogen content of 20 ppm over your pre-test level is considered a positive test. This means you may have trouble breaking down lactose. […] The blood test is considered abnormal if your glucose level rises less than 20 mg/dL (1.1 mmol/L) within 2 hours of drinking the lactose solution.

• #19 Lactose intolerance diagnostic study of choice – wikidoc

  https://www.wikidoc.org/index.php/Lactose_intolerance_diagnostic_study_of_choice

  Small bowel biopsy such as jejunal or duodenal biopsy is the gold standard test for the diagnosis of lactose intolerance. Low lactase activity in small bowel biopsy is confirmatory of lactose intolerance. The diagnostic study of choice for lactose intolerance is lactose breath hydrogen test. Lactose intolerance is diagnosed based on a rise in hydrogen concentration of 20 ppm (parts per million) and the presentation of symptoms such as bloating, diarrhea and abdominal pain. […] Nowadays, small bowel biopsy is rarely performed and it is substituted with noninvasive diagnostic tests such as lactose tolerance test and lactose breath hydrogen test. […] The diagnostic study of choice for lactose intolerance is lactose breath hydrogen test. […] Lactose malabsorption and intolerance are diagnosed based on a rise in hydrogen concentration of 20 ppm (parts per million) and the presentation of symptoms compared to baseline. […] However, investigations such as lactose breath hydrogen test and small bowel biopsy can be very helpful in the diagnosis of lactose intolerance.

• #20 Lactose intolerance: Diagnosis and diet strategies

  https://www.contemporarypediatrics.com/view/lactose-intolerance-diagnosis-and-diet-strategies

  Diarrhea, abdominal pain, and flatulence following ingestion of milk or products containing milk are common complaints in pediatric practices. The pediatrician needs to be aware of the management of lactose intolerance to help guide a reasonable workup and plan. […] Pediatricians take a varied approach to the diagnosis of lactose intolerance. Many pediatricians make a presumptive diagnosis based on history alone with the presence of symptoms with ingestion of lactose products. The diagnosis is often buttressed by symptom resolutions with avoidance and recurrence upon lactose challenge. The 2006 guideline from the American Academy of Pediatrics (AAP) states that a strict lactose-free, 2-week trial with resolution of symptoms and recurrence upon reintroduction is sufficient for diagnosis. […] This is a simple, noninvasive test wherein the patient receives a lactose load and the breath is measured for hydrogen every 15 to 30 minutes for up to 3 hours. The test looks for increased levels of hydrogen, which normally peaks in 90 to 120 minutes following the load. At 78% and 98%, respectively, the sensitivity and specificity are superior to the absorption test. It is considered the most reliable and cost-effective test for diagnosing lactose malabsorption.

• #21 Diagnosis of Lactose Intolerance – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/diagnosis

  To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. […] Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. […] Your doctor may ask you to stop eating and drinking milk and milk products for a period of time to see if your symptoms go away. If your symptoms dont go away, your doctor may order additional tests. […] Your doctor may order a hydrogen breath test to see how well your small intestine digests lactose. […] Doctors use this test to diagnose lactose malabsorption and lactose intolerance. […] If both your breath hydrogen levels rise and your symptoms get worse during the test, your doctor may diagnose lactose intolerance.

• #22 Lactose Tolerance Test: Purpose, Procedure & Results

  https://www.healthline.com/health/lactose-tolerance-tests

  A lactose tolerance test measures how well your body can process lactose, a type of sugar found in dairy products. […] This inability to digest lactose is referred to as lactose intolerance. […] There are three kinds of tests that can be used to check lactose intolerance. […] Your physician may recommend this test if you have symptoms of lactose intolerance. […] Lactose intolerance occurs more often in older adults and babies who are born prematurely. […] You may be lactose intolerant if blood glucose levels raise less than 20 milligrams per deciliter (mg/dL) within 2 hours of drinking the lactose solution.

• #23 Lactose Intolerance | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0501/p1845.html

  Persons with lactose intolerance are unable to digest significant amounts of lactose because of a genetically inadequate amount of the enzyme lactase. […] A diagnosis of lactose intolerance can usually be made with a careful history supported by dietary manipulation. If necessary, diagnosis can be confirmed by using a breath hydrogen or lactose tolerance test. […] Accurate diagnosis of lactose intolerance can significantly relieve patient anxiety and avoid inappropriate investigation and treatment. […] Diagnosis of lactose intolerance can usually be made on the basis of the history, supported by dietary manipulation. Diagnostic tests range from changes in breath hydrogen levels or serum glucose levels after ingestion of standard doses of lactose to biopsy of the small bowel. […] Two formal tests are commonly used in patients suspected of having lactose intolerance. The lactose tolerance test consists of administering an oral dose of approximately 1 to 1.5 g of lactose per kg of body weight and obtaining serial blood samples for measurement of blood glucose levels. […] The measurement of breath hydrogen after ingestion of 25 to 50 g of lactose is more sensitive and specific than the lactose tolerance test. […] The lactose breath hydrogen test is positive in 90 percent of patients with lactose malabsorption.

• #24 Lactose Tolerance Test, 4 Specimens | Test Detail | Quest Diagnostics

  https://testdirectory.questdiagnostics.com/test/test-detail/7674/lactose-tolerance-test-4-specimens?p=r&cc=MASTER

  Lactose Tolerance Test, 4 Specimens – Results may be used to evaluate deficiency of small bowel mucosal lactase, which may be associated with intolerance to lactose, manifested by diarrhea and other symptoms following ingestion of milk. […] Note: This cannot be performed at a patient service center because of the preparation step required for the lactol solution. Fasting required. Fasting is defined as no consumption of food or beverage other than water for at least 8 hours before testing. […] Immediately after a fasting specimen is obtained, have patient ingest a 50 g dose of lactose (supplied by the laboratory). Draw subsequent specimens 1/2, 1 and 2 hours later. Label each with the specific draw time. Note: Children should receive 1.75 g lactose per kg ideal body weight, up to 50 g.

• #25 Lactose tolerance tests: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/003500.htm

  Lactose tolerance tests measure the ability of your intestines to break down a type of sugar called lactose. This sugar is found in milk and other dairy products. If your body cannot break down this sugar, you are said to have lactose intolerance. This can cause gassiness, abdominal pain, cramps, and diarrhea. […] Your health care provider may order these tests if you have signs of lactose intolerance. […] Abnormal results may be a sign of lactose intolerance. […] A breath test result that shows a rise in hydrogen content of 20 ppm over your pre-test level is considered a positive test. This means you may have trouble breaking down lactose. […] The blood test is considered abnormal if your glucose level rises less than 20 mg/dL (1.1 mmol/L) within 2 hours of drinking the lactose solution.

• #26 Lactose Tolerance Test: Purpose, Procedure & Results

  https://www.healthline.com/health/lactose-tolerance-tests

  A lactose tolerance test measures how well your body can process lactose, a type of sugar found in dairy products. […] This inability to digest lactose is referred to as lactose intolerance. […] There are three kinds of tests that can be used to check lactose intolerance. […] Your physician may recommend this test if you have symptoms of lactose intolerance. […] Lactose intolerance occurs more often in older adults and babies who are born prematurely. […] You may be lactose intolerant if blood glucose levels raise less than 20 milligrams per deciliter (mg/dL) within 2 hours of drinking the lactose solution.

• #27 Lactose intolerance | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/lactose-intolerance/

  In a lactose tolerance test, you’ll be given a drink of lactose solution and a blood sample will be taken to see how much glucose it contains. […] If you’re lactose intolerant, your blood sugar levels will either rise slowly, or not at all. […] In a milk tolerance test, you’ll be given a glass of milk and your blood sugar levels will be tested. […] If your blood sugar levels don’t rise after drinking the milk, you may be lactose intolerant. […] A small bowel biopsy is rarely used to diagnose lactose intolerance, but it may be carried out to see if your symptoms are being caused by another condition. […] If it only contains a small amount of lactase, it’s likely you’re lactose intolerant.

• #28 Pediatric Lactose Intolerance Workup: Laboratory Studies, Other Tests, Procedures

  https://emedicine.medscape.com/article/930971-workup

  A trial on 60 subjects suspected of lactose malabsorption compared different breath tests and concluded that there was unsatisfactory agreement between commonly used diagnostic tests. […] The test with the best diagnostic properties was lactose breath test with 25 g lactose and measurement of the increase in the sum of H2 and CH4x2. […] A meta-analysis comparing the diagnostic accuracy of lactose breath hydrogen or lactose tolerance tests found that overall sensitivity was 0.88 (confidence interval [CI], 0.85-0.90) and specificity was 0.85 (CI, 0.82-0.87) for the breath test. […] The lactose tolerance test showed sensitivity of 0.94 (CI, 0.9-0.97) and specificity of 0.90 (CI, 0.84-0.95). […] Mucosal biopsy is almost never needed to diagnose lactose intolerance. However, it may prove useful as a part of the workup in patients with malabsorption of obscure cause.

• #29 Lactose Intolerance Workup: Laboratory Studies, Other Tests, Procedures

  https://emedicine.medscape.com/article/187249-workup

  This test is rarely done in clinical practice. Measure serial blood glucose levels after an oral lactose load. A fasting serum glucose level is obtained, after which 50 g of lactose is administered. Measure the serum glucose level at 0, 60, and 120 minutes. The lactose tolerance test has a sensitivity of 75% and a specificity of 96%. False-negative results occur in the presence of diabetes and small bowel bacterial overgrowth. Abnormal gastrointestinal emptying can also affect the results of the lactose tolerance test. The diagnosis is confirmed if the serum glucose level fails to increase by 20 g/dL above the baseline. […] Administer 500 mL of milk and measure the blood glucose level. An increase of less than 9 mg/dL indicates lactose malabsorption. […] Imaging tests are not helpful in the diagnosis of primary lactose intolerance, but they may be helpful for excluding secondary causes.

• #30 Lactose Intolerance – Cause, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/digestive-disorders/digestive-diseases-lactose-intolerance

  Millions of Americans cant digest a certain sugar in milk and milk products called lactose. If youre one of them, you have lactose intolerance. […] Your doctor can test for lactose intolerance: […] Breath test. This will show if you have high levels of hydrogen when you exhale. If you do, you might be lactose intolerant. […] Blood test. This can show how your body reacts after you drink something with a lot of lactose. […] Stool acidity test. This is the test used for children and infants. […] Genetic test. Using a sample of your blood or spit, a lab checks to see if your genes could be behind your lactose intolerance. […] Surgical biopsy. This is done in a hospital under anesthesia. The surgeon makes a cut in your stomach and takes a sample of your small intestine tissue. A lab then checks the sample for signs of lactose intolerance.

• #31 Lactose intolerance: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/180120

  Stool sample test: Lactose tolerance tests and hydrogen breath tests are not suitable for infants, so a physician may perform a stool test. High levels of acetate and other fatty acids in the stool can be a sign of lactose intolerance. […] Physicians will also want to rule out other conditions that can cause similar symptoms. These include inflammatory bowel disease, irritable bowel syndrome, and celiac disease.

• #32

  https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Lactose-Intolerance-in-Children.aspx

  Pediatricians check acidity in the stools of infants and young children who may be unable to properly do the hydrogen breath test. Acidic stool (low pH) may indicate lactose malabsorption. Another stool test (reducing substances) looks for the presence of glucose in the stool, which signifies undigested lactose. […] If your child’s symptoms persist, he or she may be referred to a pediatric gastroenterologist (GI) for further evaluation. Depending on the severity of your child’s symptoms, the GI may perform an endoscopy to measure lactase levels directly from the intestine. This is done with a biopsy. […] How lactose intolerance is treated depends on the extent of your child’s symptoms. Some children with lactose intolerance may be able to have small amounts of dairy products without having symptoms.

• #33 Lactose Intolerance – Diagnosis | Proctoclinic.gr

  https://proctoclinic.gr/en/dysaneksia-sti-laktozi-diagnosi/

  The Lactose Intolerance and Hydrogen Breath Test is not applicable to infants or very young children in whom lactose intolerance is suspected. […] In addition, if necessary, a stool acidity test is also administered to measure the amount of acid in the stool, both in infants and young children. Undigested lactose, which is fermented by the bacteria in the colon, makes lactic acid and other short chain fatty acids that can be detected in a stool sample. In addition, Glucose may also be detected in the sample as a result of Lactose that has not been absorbed in the colon.

• #34 Pediatric Lactose Intolerance Workup: Laboratory Studies, Other Tests, Procedures

  https://emedicine.medscape.com/article/930971-workup

  Laboratory studies indicated in patients with lactose intolerance are discussed below. […] The adult-type hypolactasia (most commonly caused by the CC genotype of the 13910 C/T polymorphism of the LCT gene) can now be easily diagnosed by a genetic analysis. […] Studies have determined that genetic test results and breath test results are well-correlated, thereby eliminating the need for such testing. […] A test based on the measurement of D-xylose after lactase cleavage of orally administered 4-galactosylxylose (Gaxilose) has been investigated in a large multicenter study in adults, with very good sensitivity and specificity for lactase deficiency as measured in biopsy specimens. […] Resolution of diarrhea and symptoms when a suspected substance is removed from the diet, as well as resumption of the diarrhea and symptoms when the substance is reintroduced, are very suggestive signs of intolerance.

• #35 Development of Personalized Nutrition: Applications in Lactose Intolerance Diagnosis and Management

  https://www.mdpi.com/2072-6643/13/5/1503

  In practice, the diagnosis of LI is usually made on the basis of clinical suspicion supported by the positive response to a dietary challenge such as a trial period of a lactose-free diet. […] However, several clinical diagnostic tests are available including blood, breath, and genetic tests, which can confirm a diagnosis even in the absence of gastrointestinal symptoms. […] The lactose hydrogen breath test (HBT) has been widely adopted for the detection of an increase in H2 in expired air at several time points, after an oral lactose challenge. […] Genetic testing has also emerged as a less invasive tool for supporting the diagnosis of LI and tests based on the most common SNPs that are linked to LP in the Caucasian population (LCT-13910C/T and LCT-22018G/A) have been developed. […] However, the use of these SNPs cannot be applied as a global diagnostic tool, as other polymorphisms that confer LP have been identified in several African and Arabian populations. […] Currently genetic tests have a limited role in diagnosing LI in the clinical setting, as none of them achieve perfect sensitivity and specificity and the results do not always correlate with clinical symptoms.

• #36 DNA Lactose Intolerance Test | Genex Diagnostics

  https://www.genexdiagnostics.com/dna-lactose-intolerance-test/

  People who are lactose intolerant cannot digest and absorb the milk sugar lactose, because they produce only low levels of the lactase enzyme. This causes digestive symptoms like gas, bloating and diarrhea, when dairy products are consumed. […] People with at least one of these variants are unlikely to suffer from lactose intolerance. Those that do not carry any of these variants have an increased risk of lactose intolerance. […] The likelihood of lactose intolerance depends on ethnicity. Lactose intolerance is the normal phenotype. The mutations associated with lactase persistence occurred, and were selected for, when there was an increased reliance on dairy as a food source. […] Lactose intolerance causes undigested lactose to build up in the large intestine, resulting in the growth of gas-producing gut bacteria. Symptoms include:

• #37 Development of Personalized Nutrition: Applications in Lactose Intolerance Diagnosis and Management

  https://www.mdpi.com/2072-6643/13/5/1503

  In practice, the diagnosis of LI is usually made on the basis of clinical suspicion supported by the positive response to a dietary challenge such as a trial period of a lactose-free diet. […] However, several clinical diagnostic tests are available including blood, breath, and genetic tests, which can confirm a diagnosis even in the absence of gastrointestinal symptoms. […] The lactose hydrogen breath test (HBT) has been widely adopted for the detection of an increase in H2 in expired air at several time points, after an oral lactose challenge. […] Genetic testing has also emerged as a less invasive tool for supporting the diagnosis of LI and tests based on the most common SNPs that are linked to LP in the Caucasian population (LCT-13910C/T and LCT-22018G/A) have been developed. […] However, the use of these SNPs cannot be applied as a global diagnostic tool, as other polymorphisms that confer LP have been identified in several African and Arabian populations. […] Currently genetic tests have a limited role in diagnosing LI in the clinical setting, as none of them achieve perfect sensitivity and specificity and the results do not always correlate with clinical symptoms.

• #38 How does the Diagnosis of lactose intolerance – nmi-Portal – Ernährung im Fokus% work?

  https://www.nahrungsmittel-intoleranz.com/en/diagnosis-of-lactose-intolerance/

  The entire procedure takes about 3-4 hours. If the lactose is not properly metabolized, bacteria in the large intestine produce hydrogen, which passes through the blood into the breath and can be measured there. Based on the measurement curve, the doctor can determine or rule out lactose intolerance. […] In addition to the measured values, the symptoms occurring during the test are also important for the diagnosis. […] If symptoms such as abdominal pain (lower abdomen), flatulence and diarrhea occur, intolerance can be assumed. […] The doctor will either take a cheek swab or draw blood. The sample is then sent to the genetic laboratory where it is analyzed. This test can only detect a genetic predisposition to age-related lactose tolerance. However, it says nothing about whether you actually develop an intolerance.

• #39 Lactose intolerance diagnostic study of choice – wikidoc

  https://www.wikidoc.org/index.php/Lactose_intolerance_diagnostic_study_of_choice

  Small bowel biopsy such as jejunal or duodenal biopsy is the gold standard test for the diagnosis of lactose intolerance. Low lactase activity in small bowel biopsy is confirmatory of lactose intolerance. The diagnostic study of choice for lactose intolerance is lactose breath hydrogen test. Lactose intolerance is diagnosed based on a rise in hydrogen concentration of 20 ppm (parts per million) and the presentation of symptoms such as bloating, diarrhea and abdominal pain. […] Nowadays, small bowel biopsy is rarely performed and it is substituted with noninvasive diagnostic tests such as lactose tolerance test and lactose breath hydrogen test. […] The diagnostic study of choice for lactose intolerance is lactose breath hydrogen test. […] Lactose malabsorption and intolerance are diagnosed based on a rise in hydrogen concentration of 20 ppm (parts per million) and the presentation of symptoms compared to baseline. […] However, investigations such as lactose breath hydrogen test and small bowel biopsy can be very helpful in the diagnosis of lactose intolerance.

• #40 Lactose intolerance | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/lactose-intolerance/

  In a lactose tolerance test, you’ll be given a drink of lactose solution and a blood sample will be taken to see how much glucose it contains. […] If you’re lactose intolerant, your blood sugar levels will either rise slowly, or not at all. […] In a milk tolerance test, you’ll be given a glass of milk and your blood sugar levels will be tested. […] If your blood sugar levels don’t rise after drinking the milk, you may be lactose intolerant. […] A small bowel biopsy is rarely used to diagnose lactose intolerance, but it may be carried out to see if your symptoms are being caused by another condition. […] If it only contains a small amount of lactase, it’s likely you’re lactose intolerant.

• #41 Lactose Intolerance – Cause, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/digestive-disorders/digestive-diseases-lactose-intolerance

  Millions of Americans cant digest a certain sugar in milk and milk products called lactose. If youre one of them, you have lactose intolerance. […] Your doctor can test for lactose intolerance: […] Breath test. This will show if you have high levels of hydrogen when you exhale. If you do, you might be lactose intolerant. […] Blood test. This can show how your body reacts after you drink something with a lot of lactose. […] Stool acidity test. This is the test used for children and infants. […] Genetic test. Using a sample of your blood or spit, a lab checks to see if your genes could be behind your lactose intolerance. […] Surgical biopsy. This is done in a hospital under anesthesia. The surgeon makes a cut in your stomach and takes a sample of your small intestine tissue. A lab then checks the sample for signs of lactose intolerance.

• #42 Lactose intolerance | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/lactose-intolerance/

  In a lactose tolerance test, you’ll be given a drink of lactose solution and a blood sample will be taken to see how much glucose it contains. […] If you’re lactose intolerant, your blood sugar levels will either rise slowly, or not at all. […] In a milk tolerance test, you’ll be given a glass of milk and your blood sugar levels will be tested. […] If your blood sugar levels don’t rise after drinking the milk, you may be lactose intolerant. […] A small bowel biopsy is rarely used to diagnose lactose intolerance, but it may be carried out to see if your symptoms are being caused by another condition. […] If it only contains a small amount of lactase, it’s likely you’re lactose intolerant.

• #43 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Lactose-Intolerance-Diagnosis.aspx

  Lactose intolerance is frequently and mistakenly self-diagnosed. Diagnosis should not be based on clinical symptoms alone and should be made by a physician who has performed certain laboratory tests. […] Lactose intolerance is usually diagnosed in the following way: A patient is asked to maintain a food diary recording everything they eat or drink. The physician may instruct a patient to remove lactose from their diet completely for two weeks and reassess the presence or absence of symptoms afterwards. If symptoms are absent, the lactose intolerance is likely. A patient may be asked to undergo a blood sugar test. After an overnight fast, a patient drinks lactose solution and the sugar level of the blood is checked. If the patient is intolerant to lactose, blood sugar levels will either rise slowly, or not at all because the sugar from the lactose solution is not absorbed in the blood at a normal rate. A variant of the blood sugar test is the milk tolerance test, in which case a patient is given around 500ml of milk to drink after their overnight fast instead of lactose solution. Again, if blood shows no change in sugar level then the patient is considered to be lactose intolerant. The hydrogen breath test is a simple and very useful test that often confirms lactose intolerance. The person is asked to fast overnight, then given a lactose solution to drink after which they breathe into an instrument that measures the concentration of hydrogen (parts per million, ppm) in their breath. People who exhale a large amount of hydrogen (20 ppm above the initial value) in an hour are diagnosed as lactose intolerant. The stool acidity test is another useful test for the condition in infants and young children. If the lactose remains undigested, it is converted by bacteria to lactic acid and other fatty acids that can be detected in the stool. Furthermore, glucose may also be detected in stools. One test that may be performed in diagnosing lactose intolerance is a stool bowel biopsy. However, this test is invasive and may require a hospital stay. It is rarely used to diagnose lactose intolerance but more to rule out other conditions such as celiac disease. A small amount of tissue is taken from the inside of the intestinal wall under local anaesthetic using an endoscope for guidance. The sample of tissue is then stained and examined under a microscope and tested to see how much lactase it contains. Low levels of lactase indicate lactose intolerance.

• #44 Lactose Intolerance (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/lactose-intolerance-pro

  To diagnose lactose intolerance, oral lactose is given after overnight fasting and an increase greater than 20 parts per million (ppm) of hydrogen is diagnostic. […] The gold standard test is analysis of enzyme and carbohydrate levels and ratios from biopsy; however, it is usually too invasive a test for a mild condition.

• #45

  https://link.springer.com/article/10.1007/s42399-021-00792-9

  In response to the hypotheses put forward over time regarding the genetic predisposition to lactose intolerance, polymorphisms of the gene that codes for lactase predisposing to this intolerance have been identified. […] Quick Lactose Intolerant Test consists in execution of mucosal biopsies at the post-bulbar duodenum level and their subsequent incubation with lactose on test plate. […] Lactose Tolerance Test (LTT) involves the administration of 50 g of lactose and the glycaemia dosage before lactose intake and after 30 min, 60 min, and 120 min based on plasma-glucose dosage after lactose ingestion. […] This is a new non-invasive test that consists of administration of Gaxilose (4-O–D-galactopyranosyl-D-xylose), a synthetic disaccharide provided with a structure similar to lactose. […] On the basis of above, it is possible to state that, among the diagnostic methods available today, HBT represents the most valid choice both in terms of diagnostic accuracy and inexpensiveness.

• #46 Pediatric Lactose Intolerance Workup: Laboratory Studies, Other Tests, Procedures

  https://emedicine.medscape.com/article/930971-workup

  Laboratory studies indicated in patients with lactose intolerance are discussed below. […] The adult-type hypolactasia (most commonly caused by the CC genotype of the 13910 C/T polymorphism of the LCT gene) can now be easily diagnosed by a genetic analysis. […] Studies have determined that genetic test results and breath test results are well-correlated, thereby eliminating the need for such testing. […] A test based on the measurement of D-xylose after lactase cleavage of orally administered 4-galactosylxylose (Gaxilose) has been investigated in a large multicenter study in adults, with very good sensitivity and specificity for lactase deficiency as measured in biopsy specimens. […] Resolution of diarrhea and symptoms when a suspected substance is removed from the diet, as well as resumption of the diarrhea and symptoms when the substance is reintroduced, are very suggestive signs of intolerance.

• #47 Pediatric Lactose Intolerance Workup: Laboratory Studies, Other Tests, Procedures

  https://emedicine.medscape.com/article/930971-workup

  Laboratory studies indicated in patients with lactose intolerance are discussed below. […] The adult-type hypolactasia (most commonly caused by the CC genotype of the 13910 C/T polymorphism of the LCT gene) can now be easily diagnosed by a genetic analysis. […] Studies have determined that genetic test results and breath test results are well-correlated, thereby eliminating the need for such testing. […] A test based on the measurement of D-xylose after lactase cleavage of orally administered 4-galactosylxylose (Gaxilose) has been investigated in a large multicenter study in adults, with very good sensitivity and specificity for lactase deficiency as measured in biopsy specimens. […] Resolution of diarrhea and symptoms when a suspected substance is removed from the diet, as well as resumption of the diarrhea and symptoms when the substance is reintroduced, are very suggestive signs of intolerance.

• #48 Lactose intolerance and lactase deficiency – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/798

  1st tests to order include trial of dietary lactose elimination and CBC. […] Tests to consider include lactose hydrogen breath test, stool culture, fecal pH, fecal reducing substance/sugar, lactose tolerance test, and small bowel biopsy. […] Emerging tests include genotyping and 13C-labeled lactose breath test.

• #49 How does the Diagnosis of lactose intolerance – nmi-Portal – Ernährung im Fokus% work?

  https://www.nahrungsmittel-intoleranz.com/en/diagnosis-of-lactose-intolerance/

  In very rare cases, a tissue sample can be taken from the small intestine and tested for lactose intolerance. […] Alternatively, a so-called 13C breath test could be carried out to diagnose lactose intolerance. […] A glass of lactose solution is drunk under medical supervision. The subsequent laboratory measurements of the blood sugar level show whether the milk sugar is broken down into glucose and galactose, which increases the blood sugar level. […] These tests are not suitable for detecting lactose intolerance, fructose malabsorption or histamine intolerance.

• #50 Lactose intolerance and lactase deficiency – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/798

  1st tests to order include trial of dietary lactose elimination and CBC. […] Tests to consider include lactose hydrogen breath test, stool culture, fecal pH, fecal reducing substance/sugar, lactose tolerance test, and small bowel biopsy. […] Emerging tests include genotyping and 13C-labeled lactose breath test.

• #51 Lactose intolerance: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/180120

  Stool sample test: Lactose tolerance tests and hydrogen breath tests are not suitable for infants, so a physician may perform a stool test. High levels of acetate and other fatty acids in the stool can be a sign of lactose intolerance. […] Physicians will also want to rule out other conditions that can cause similar symptoms. These include inflammatory bowel disease, irritable bowel syndrome, and celiac disease.

• #52 Lactose Intolerance vs. Dairy Allergy: Symptoms, Diagnosis, Living With

  https://www.webmd.com/digestive-disorders/lactose-intolerance-or-dairy-allergy

  Stool acidity test. Babies and children who can’t be tested otherwise can have their stool tested for lactic acid caused by the breakdown of undigested lactose in the colon. […] Tests for dairy allergy […] […] Skin prick test. A small drop of liquid containing the dairy allergen is placed under the skin on your forearm or back. If it causes a raised bump to form, surrounded by itchy red skin, you likely have a dairy allergy. Blood test. This can measure certain antibodies that can develop in your blood if you have a dairy allergy. […] Both tests can have false positives. You can test positive for an allergy even though you really don’t have it. You can also test negative if you do have one. […] If your doctor still isn’t sure if you have a dairy allergy, they might suggest you try an oral challenge. You’ll be fed increasing amounts of different foods that may or may not contain milk to see how you react. Because of the risk of a severe reaction, this test is done at a doctor’s office.

• #53 Lactose intolerance and malabsorption: Clinical manifestations, diagnosis, and management – UpToDate

  https://www.uptodate.com/contents/lactose-intolerance-and-malabsorption-clinical-manifestations-diagnosis-and-management

  Lactose intolerance and malabsorption: Clinical manifestations, diagnosis, and management […] Intolerance to lactose-containing foods is common. Symptoms of lactose intolerance are abdominal pain, flatulence, nausea, bloating, and diarrhea after ingestion of milk or milk-containing products. These symptoms may be associated with lactose malabsorption, which results from low levels of small intestinal lactase. However, these symptoms may also occur after ingestion of lactose or lactose-containing foods without demonstrable malabsorption. This topic will review the causes, clinical manifestations, diagnosis, and management of lactose intolerance and malabsorption. Our recommendations are largely consistent with the European guideline, with a focus on the definition and diagnostic evaluation of lactose malabsorption and lactose intolerance.

• #54 Can lactose intolerance be self-diagnosed? – Yogurt in Nutrition

  https://www.yogurtinnutrition.com/can-lactose-intolerance-be-self-diagnosed/

  Its not possible to self-diagnose lactose intolerance. This also includes the tests you could find on the Internet, as these tests are not scientifically validated. […] lactose intolerance cannot be diagnosed outside strict medical control. The proper way to diagnose lactose intolerance is to measure, in the exhaled air, the hydrogen produced by the intestinal flora after consumption of a standard dose of lactose (usually 20 to 50g) and when one or many of the following symptoms occur: bloating, diarrhea, and flatulence. This diagnosis if performed under medical control. […] When a medical diagnosis is performed, only 50% of self-diagnosis of lactose intolerance is confirmed.

• #55 Lactose intolerance

  https://www.rch.org.au/kidsinfo/fact_sheets/Lactose_intolerance/

  Lactose intolerance can be investigated by assessing a sample of your child’s stool (poo) or via a breath-test. Discuss these different tests with your child’s doctor. […] If your child has symptoms of lactose intolerance, take them to see a GP. The doctor will be able to determine if your child is lactose intolerant and rule out other conditions. They may do some investigations and recommend that you see a dietician. It is important not to self-diagnose your child and make changes to their diet without consulting a doctor or dietitian.

• #56 Lactose Intolerance: What Your Breath Can Tell You

  https://www.mdpi.com/2075-4418/10/6/412

  Diagnosis of lactose intolerance requires concomitant assessment of lactose digestion and abdominal symptoms, with the usage of diagnostic procedures to aid in proper identification of intolerance. […] Though, out of all the lactose intolerance diagnostic tests, several studies have suggested that the HBT is superior, especially to the lactose tolerance test which measures an increase in blood sugar after lactose is given as a challenge.

• #57 Lactose Intolerance in Children

  https://www.nationwidechildrens.org/conditions/health-library/lactose-intolerance-in-children

  Lactose intolerance is when the body cant easily break down or digest lactose. […] Lactose intolerance is different from having a food allergy to milk. […] The symptoms of lactose intolerance may look like other health conditions. Always see your child’s healthcare provider for a diagnosis. […] Your child’s healthcare provider will give your child a physical exam and take a health history. […] Your child may need to be tested. The most common tests used to check how lactose is absorbed in the digestive system include: […] Lactose tolerance test. This test checks how lactose is absorbed by your child’s digestive system. […] Hydrogen breath test. Your child drinks a liquid that has a lot of lactose. […] Stool acidity test. This test is used for babies and young children. […] Have your child see a healthcare provider for a diagnosis. […] You can manage your child’s symptoms by limiting foods that have lactose.

• #58 Lactose Intolerance – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/malabsorption/lactose-intolerance

  Lactose intolerance is the inability to digest the sugar lactose because of a lack of the digestive enzyme lactase, leading to diarrhea and abdominal cramping. […] The diagnosis is based on recognizing that symptoms occur after a person has consumed dairy products and can be confirmed with a hydrogen breath test. […] A doctor suspects lactose intolerance when a person has symptoms after consuming dairy products. If a 3- to 4-week trial period of a diet free of dairy products eliminates the symptoms, and symptoms then return when the person consumes dairy products, the diagnosis is confirmed. […] Specific tests are rarely necessary, but in some people, doctors confirm the diagnosis with a breath test. […] The hydrogen breath test (also called a lactose breath test) is a 4-hour test.

• #59 Causes and diagnosis of lactose intolerance | informedhealth.org

  https://www.informedhealth.org/causes-and-diagnosis-of-lactose-intolerance.html

  The hydrogen breath test and lactose tolerance test measure whether your body can break down and absorb the lactose properly. They dont provide any information about the cause of your symptoms. So its important to look out for symptoms like diarrhea and cramps as well during the test. You can only be certain that youre lactose-intolerant if the lactose solution also causes typical symptoms. […] You dont need to do all the tests. The hydrogen breath test is the standard in Germany and many other countries.

• #60 Lactose intolerance and malabsorption: Clinical manifestations, diagnosis, and management – UpToDate

  https://www.uptodate.com/contents/lactose-intolerance-and-malabsorption-clinical-manifestations-diagnosis-and-management

  The terms „lactase deficiency,” „lactose malabsorption,” and „lactose intolerance” describe different aspects of a pathogenetic process. Not all patients with lactose intolerance will have lactase deficiency or lactose malabsorption. Each of these conditions has different clinical relevance and therapeutic consequences. […] „Lactose intolerance” refers to reports of gastrointestinal symptoms after ingesting lactose or lactose-containing food. […] „Lactose malabsorption” refers to incomplete absorption of lactose in the small intestine with the consequence that ingested lactose reaches the colon. The ingestion of lactose-containing food by people who have primary lactase deficiency is the most common cause of lactose malabsorption worldwide. Lactose malabsorption may result in symptoms (intolerance) that can be treated by diet and other means. […] „Lactase deficiency” refers to a lack of the activity of the enzyme lactase, which is the disaccharidase responsible for digestion of the disaccharide lactose. Lactase-deficient persons who are exposed to lactose may develop lactose malabsorption, depending on the amount of ingested lactose.

• #61 How to Test for Lactose Intolerance – Canadian Digestive Health Foundation

  https://cdhf.ca/en/how-to-test-for-lactose-intolerance/

  A glucose blood test can also be used to test for lactose intolerance. Measuring the amount of glucose in your blood helps assess whether you’re lactose intolerant because if your body cannot digest lactose, it will not get broken down into glucose and galactose, and your blood levels of glucose won’t rise. If your blood glucose levels don’t rise, you likely have lactose intolerance. […] Once you’ve been diagnosed with lactose intolerance, there are many ways to manage symptoms while maintaining a balanced diet. Testing for lactose intolerance helps confirm a diagnosis to prevent unnecessary food restrictions. If you suspect you may have lactose intolerance, it’s important to seek guidance from a healthcare provider.

• #62 Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management | Gut

  https://gut.bmj.com/content/68/11/2080

  A National Institute of Health consensus conference defined LI as the onset of GI symptoms following a blinded, single-dose challenge of ingested lactose by an individual with LM, which are not observed when the person ingests an indistinguishable placebo, thus supporting the case for blinded testing of symptoms. […] The major limitation of the genetic, enzymatic and gaxilose tests is that LM is common in healthy individuals, and a positive test does not confirm that symptoms are caused by this condition. […] Therapy of lactose intolerance aims to improve patient symptoms and to avoid risk for undernutrition or malnutrition in the long term. […] Lactase supplementation by tablets improves both lactose digestion (reduced H2 production) and symptoms although the effects are modest.

• #63

  https://www.healthxchange.sg/digestive-system/stomach/lactose-intolerance-diagnosis-tips-cope

  Lactose Intolerance: Diagnosis and Tips to Cope […] How is lactose intolerance diagnosed? A simple self-test can help you determine your status – temporarily limit milk products in your diet. If your bothersome symptoms disappear, you are probably lactose intolerant. A doctor can use specific tests to diagnose lactose intolerance. Such testing can include a blood test as well as a hydrogen breath test to evaluate your bodys reaction after drinking a high-lactose solution, say doctors from the Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH), a member of the SingHealth group. […] Depending on individual tolerance, people with lactose intolerance may be able to consume milk and dairy products in small amounts. They should always make sure that they get enough calcium and other nutrients from non-dairy sources in their diet.

• #64 Lactose Intolerance – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532285/

  Once a diagnosis of lactose intolerance is made, consultation should be made with a gastroenterologist and dietician. […] Management of lactose intolerance consists of dietary modification, lactase supplementation, and treating an underlying condition in people with secondary lactase deficiency. […] Lactase enzyme supplements contain lactase which breaks down lactose in milk and milk-containing products. […] Lactose intolerance is commonly confused with milk allergy. Lactose intolerance is a gastrointestinal disorder, while milk allergy is an autoimmune reaction against specific milk proteins.

• #65

  https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Lactose-Intolerance-in-Children.aspx

  To help alleviate symptoms if/when your child consumes lactose-containing food, your pediatrician may recommend an over-the-counter lactase enzyme supplement. […] If your child’s symptoms are severe and warrant removing all lactose from his or her diet, your pediatrician may refer your child to a registered dietitian. Since dairy is a good source of calcium and vitamin Dwhich all kids needa registered dietitian can suggest other foods to provide those nutrients and may suggest vitamin supplements. […] In some cases, lactose intolerance is temporaryif lactose intolerance develops after a viral illness or if it is associated with other conditions, like celiac disease. For example, once celiac disease is treated, lactase levels can become in the normal range and lactose may be tolerated in the diet. More than likely, however, lactose intolerance is long-term and requires many older children and adults to alter their diet to avoid symptoms.

• #66

  https://bpac.org.nz/2021/lactose-intolerance.aspx

  Primary lactase deficiency, the main cause of lactose intolerance, is estimated to affect 8% of people in New Zealand, with substantially higher rates among Mori, Pacific and southeast Asian peoples. […] Lactose intolerance can usually be diagnosed through dietary challenge, i.e. the return of symptoms following reintroduction of milk and milk products after an elimination period. […] Lactose intolerance is initially treated by minimising or avoiding lactose-containing foods, however, most people can eventually tolerate one to two glasses of milk daily, if consumed in small portions with food. […] A lactose-free diet should be trialled for two to four weeks when lactose intolerance is suspected. […] If symptoms improve during the two to four week period and return when lactose is reintroduced, the diagnosis can be made.

• #67 Lactose Intolerance | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/lactose-intolerance.html

  Lactose intolerance is when your body can’t break down or digest lactose. […] Lactose intolerance is not the same thing as having a food allergy to milk. […] Your health care provider will talk to you about your past health and family history. They will give you a physical exam. […] You may also have some tests to check for lactose intolerance. These may include: […] Hydrogen breath test. You will drink a liquid that has a lot of lactose. Your breath will be checked several times. High levels of hydrogen in your breath may mean you are lactose intolerant. This is the most common way to test. […] Lactose tolerance test. This test checks how your digestive system absorbs lactose. […] Stool acidity test. This test is used for infants and young children. It checks how much acid is in the stool. If someone is not digesting lactose, their stool will have lactic acid, glucose, and other fatty acids.

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