Abstract :
Objectives: To determine the prevalence of lactose intolerance in patients with functional dyspepsia
and to document the association of changing in duodenal villi in Thai patients with lactose malabsorption by using breath hydrogen excretion test.
Patients and Methods: Functional dyspepsia patients who had no history of milk allergy and under-
went gastroduodenoscopy. Two mucosal biopsy specimens were taken from beyond the distal end of the second part of the duodenum. The specimens were carefully orientated and were graded according to the following scheme: group I : finger shaped villi; group II : mixed finger and leaf shaped villi; group III : clubbing or blunting shaped villi. All subjects were tested for lactose malabsorption by breath hydrogen analysis after consuming 50 gram lactose. Breath hydrogen concentration was analyzed in samples collected intermittently by end-expiratory technique. A rise in breath hydrogen concentration of 20 PPM over baseline was considered an evidence of lactose malabsorption.
Results: Twenty-five subjects were twenty females (80.0%) and five males (20.0%) ranging in age
from 18 to 53 years (mean 31(8.29). Sixteen subjects belong to a finger shaped villi group (64.0%), five to a mixed finger and leaf shaped villi group (20.0%) and four to a clubbing or blunting shaped villi group (16.0%). Results of breath hydrogen excretion test identified the prevalence of lactose intolerance in 68% of the subjects: 15/16 (93.75%) of group I ; 1/5 (20.0%) of group II and 1/4 (25%) of group III respectively ( P<0.001). The symptom of diarrhea after lactose loading was correlated well with patients who positive of breath hydrogen analysis.
Conclusion: The changing of decreased prevalence in tropical enteropathy is found and the lactose
intolerance is not associated with changing of intestinal villi in Thai people.
Key words : Lactose intolerance, intestinal villi, functional dyspepsia
[Thai J Gastroenterol 2004; 5(1): 14-18]
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file/Thai-Journal-of-gastroenterology-vol-5-no-1-117393.pdf