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Lactose Intolerance

Nihal K. Patel, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Lactose intolerance is a syndrome of abdominal pain, bloating, and flatulence after the ingestion of lactose.

  • Lactose malabsorption results from a reduction in lactase activity in the...

DIAGNOSIS

  • Lactose intolerance can be presumed in patients manifesting mild symptoms after ingestion of significant amounts of lactose (such as >2 servings of dairy per day), with resolution of symp...

TREATMENT

There is insufficient evidence to recommend any particular treatment (including probiotics, colonic adaptation, and other supplements) as definitive first line. 
  • In the absence of a correctab...

ONGOING CARE

DIET

  • Reduce or restrict dietary lactose to control symptoms—patient-specific “trial and error.”

  • Yogurt and fermented products such as hard cheese are often better tolerated than milk.

  • Supple...

REFERENCES

1
Mattar R, de Campos Mazo DF, Carrilho FJ. Lactose intolerance: diagnosis, genetic, and clinical factors. Clin Exp Gastroenterol.  2012;5:113–121. [View Abstract on OvidMedline]
2
Gasbar...

ADDITIONAL READING

  • Almeida CC, Lorena SL, Pavan CR, et al. Beneficial effects of long-term consumption of a probiotic combination of Lactobacillus casei Shirota and Bifidobacterium breve Yakult may pe...

CODES

ICD10

  • E73.9 Lactose intolerance, unspecified

  • E73.8 Other lactose intolerance

  • E73.1 Secondary lactase deficiency

  • E73.0 Congenital lactase deficiency

ICD9

271.3 Intestinal disaccharidase deficiencies an...

CLINICAL PEARLS

  • The diagnosis of lactose intolerance is based on clinical history and confirmed by hydrogen breath testing.

  • Most lactose-intolerant patients can tolerate up to 12 to 15 g of lactose per...

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