Incidence and clinical significance of lactose malabsorption in adult coeliac disease.
Fifty-one adult patients with coeliac disease, verified by a proximal small-intestinal biopsy, were investigated. Before treatment with a gluten-free and low-lactose diet 52% showed a slight rise in blood glucose during the lactose tolerance test. Seventy-nine per cent of these patients had watery stools, and 88% had three or more bowel movements a day--statistically significantly different from the coeliac patients with a normal lactose tolerance test. After treatment 12% had a flat lactose tolerance curve. Half of them (6%) had specific lactase deficiency. This is approximately the incidence of lactose malabsorption in the general Danish population. The small-intestinal disaccharidases and alkaline phosphatase levels were severely depressed before treatment. After treatment the activities increased, but not to normal. We conclude that lactose malabsorption is a clinically important condition in many patients with untreated coeliac disease, giving rise to more frequent and more watery stools. In well-treated coeliac disease lactose malabsorption is not commoner than in the general population. The lactose activity in a proximal intestinal biopsy specimen was found to be an unreliable indicator of lactose malabsorption in coeliac disease.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002446:Celiac Disease / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000201:enzymology; D007787:Lactose Intolerance / Q000209:etiology* / Q000378:metabolism; D007789:Lactose Tolerance Test; D008297:Male; D008875:Middle Aged; D001616:beta-Galactosidase / Q000378:metabolism
D001786:Blood Glucose; D001616:beta-Galactosidase