title: Is the subjective perception of lactose intolerance influenced by the psychological profile?
abstract: BACKGROUND
  Symptoms of lactose intolerance are often attributed to lactose malabsorption but, as this relationship has not been demonstrated when a small dose of lactose similar to that contained in one cup of milk is ingested by intolerant patients, psychological factors may play a role in altered symptom perception.
  
  
  OBJECTIVE
  To assess the hypothesis that the psychological profile influences the symptoms of lactose intolerance.
  
  
  METHODS
  One hundred and two consecutive patients underwent a 15 g lactose hydrogen breath test to assess lactose malabsorption. The patients recorded the presence and severity of symptoms of lactose intolerance during the breath test using visual analogue scales. The psychological profile was assessed using a psychological symptom checklist, and health-related quality of life by means of the short-form health survey.
  
  
  RESULTS
  Lactose malabsorption and intolerance were diagnosed in, respectively, 18% and 29% of the patients. The two conditions were not associated, and the severity of intolerance was even less in the patients with malabsorption. Multivariate logistic analysis showed that a high somatisation t-score was significantly associated with lactose intolerance (odds ratio 4.184; 1.704-10.309); the effects of the other psychological variables and of lactose malabsorption were not statistically significant. Health-related quality of life was significantly reduced in the patients with somatisation, but not in those with lactose malabsorption.
  
  
  CONCLUSIONS
  The symptoms of lactose intolerance during hydrogen breath testing at a low physiological lactose load, are unrelated to lactose malabsorption, but may reveal a tendency towards somatisation that could impair the quality of life.
authors.affiliation: Post-graduate School of Gastroenterology, Università degli Studi di Milano, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tomba
authors.forename: A
authors.initials: A
authors.lastname: Baldassarri
authors.forename: M
authors.initials: M
authors.lastname: Coletta
authors.forename: B M
authors.initials: BM
authors.lastname: Cesana
authors.forename: G
authors.initials: G
authors.lastname: Basilisco
mesh_terms: D000328:Adult; D001944:Breath Tests; D005260:Female; D006801:Humans; D007785:Lactose / Q000008:administration & dosage* / Q000009:adverse effects; D007787:Lactose Intolerance / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010551:Personality; D010556:Personality Tests; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D007785:Lactose