title: Prevalence of Lactose Malabsorption and Lactose Intolerance in Pediatric Patients with Selected Gastrointestinal Diseases.
abstract: BACKGROUND
  Lactase is an enzyme involved in the hydrolysis of lactose. Deficiency of the enzyme (hypolactasia) may be determined genetically or arise secondarily to disease of small intestine. Under this condition, lactose enters the colon where it is fermented by intestinal microflora and turns to gases and short-chain fatty acids, causing gastrointestinal symptoms known as lactose intolerance (LI).
  
  
  OBJECTIVE
  To investigate the incidence of lactose malabsorption (LM), LI and the coexistence of these two conditions in children with upper gastrointestinal tract diseases (UGTD), malabsorption syndrome, inflammatory bowel disease (IBD) and functional gastrointestinal disorders (FGID).
  
  
  METHODS
  Hydrogen breath test (HBT) was conducted in 387 pediatric patients in years 2010-2013. Two hundred thirty two children with gastrointestinal tract diseases were selected and assigned to groups - UGTD, malabsorption syndrome, IBD or FGID. For each group the frequency of LM, frequency and severity of LI and the frequency of their co-occurrence were calculated.
  
  
  RESULTS
  Lactose malabsorption was observed in 37.08% of patients with gastrointestinal diseases. Positive HBT result was the most common in children with malabsorption syndrome (52.50%) and less common in UGTD (30.85%), especially in ulcer disease (23.53%). Symptoms after lactose ingestion affected 36.64% of the subjects, and were more specific to lactose malabsorbers than to lactose absorbers (72.10% vs. 15.75%). The higher frequency of LI was noted in children with FGID, especially in irritable bowel syndrome (IBS) (65.22%). The lowest incidence of symptoms was obtained in children with UGTD, especially in those with ulcer disease (27.44%). The incidence of LM with LI was noted in 27.16% of all patients and was the highest in IBS (47.83%) and the lowest in ulcer disease (15.78%).
  
  
  CONCLUSIONS
  Lactose malabsorption is a common problem in children with gastrointestinal diseases, especially in children with bowel diseases. Lactose intolerance is related to LM, but does not affect all malabsorbers.
authors.affiliation: 2nd Chair and Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Pawłowska
authors.affiliation: Department of Human Biology, University of Wrocław, Poland.
authors.forename: Wioleta
authors.initials: W
authors.lastname: Umławska
authors.affiliation: 2nd Chair and Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Iwańczak
mesh_terms: D000293:Adolescent; D001944:Breath Tests / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D015994:Incidence; D007223:Infant; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000453:epidemiology; D007785:Lactose / Q000378:metabolism* / Q000493:pharmacokinetics; D007787:Lactose Intolerance / Q000175:diagnosis / Q000453:epidemiology*; D008286:Malabsorption Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index
chemical_list: D006859:Hydrogen; D007785:Lactose