Hf. Hammer et al., EVALUATION OF THE PATHOGENESIS OF FLATULENCE AND ABDOMINAL CRAMPS IN PATIENTS WITH LACTOSE-MALABSORPTION, Wiener Klinische Wochenschrift, 108(6), 1996, pp. 175-179
Aim of this study was to assess whether the interindividual difference
s in the development of flatulence and cramps in patients with lactose
malabsorption are due to the quantity of malabsorbed lactose or gas a
ccumulation, or if accelerated intestinal transit or increased percept
ion of gas might play a role. Hydrogen breath tests were performed in
43 patients with lactose malabsorption after ingestion of 50 g lactose
and, on a separate day, 25 g lactulose. The unabsorbed amount of lact
ose, small bowel transit time and colonic hydrogen accumulation were a
ssessed in patients who did and did not develop flatulence and cramps
after ingestion of lactose. The unabsorbed amount of lactose, small bo
wel transit time and volume and rate of colonic hydrogen accumulation
were the same in patients who did or did not have symptoms after lacto
se. Patients with flatulence and cramps had a significantly longer tim
e interval between the onset of the increase and peak breath hydrogen
concentration (p < 0.05) and a significant correlation between the tim
e of occurrence of peak symptoms and the time of peak breath hydrogen
concentration (r = 0.75, p < 0.001). Our data suggest that subjective
symptoms of lactose intolerance are not due to the amount of malabsorb
ed lactose or to the volume or rate of gas accumulation per se, but ar
e related to increased perception of gas.