PROSPECTIVE-STUDY OF LACTASE ABSORPTION DURING CANCER-CHEMOTHERAPY - FEASIBILITY OF A YOGURT-SUPPLEMENTED DIET IN LACTOSE MALABSORBERS

Chemotherapy is a recognized cause of morphological alterations to the proximal intestine. Lactose malabsorption, the functional consequence of a small intestinal enzymatic derangement, has been shown to play a n important role in causing gastrointestinal symptoms in subjects rece iving chemotherapy. To establish a rational basis for the exclusion of lactose from the diet and to reduce the risk of developing gastrointe stinal symptoms, we conducted a study of lactose absorption in 20 chil dren during cancer chemotherapy. Because lactose is an important nutri tional sugar, the tolerance of lactose provided by yogurt was examined . Lactose absorption was investigated by a hydrogen breath test (BT) a fter oral ingestion of milk (250 ml) containing physiological doses of lactose (12 g). The effect of yogurt supplementation was also tested by BT after meals of yogurt (450 g) also containing physiological dose s of lactose (12.1 g). In 11 children, lactose malabsorption was detec ted by BT during the study before any gastrointestinal symptom reveale d this status. Of these 11 children, no gastrointestinal discomfort de veloped in five receiving a lactose-excluded diet. In contrast, in the six children not restricted in lactose intake, gastrointestinal sympt oms were observed 4 to 13 weeks after lactose malabsorption was detect ed by BT. The findings of our study suggested the usefulness of dietar y supplementation with yogurt, a lactose-containing food, in children who developed lactose malabsorption. In fact, all lactose-malabsorbent children showed good lactose absorption and tolerance when tested by yogurt BT. Furthermore, a yogurt-supplemented diet was also successful in three subjects initially recognized as lactose intolerant. In conc lusion, the data presented have important implications in reducing the risk of developing gastrointestinal symptoms in children receiving ca ncer chemotherapy.