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Is There a Correlation Between Irritable Bowel Syndrome and Lactose Intolerance?
Ivan Cancarevic1, Mahnoor Rehman1, Beshoy Iskander1
1Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus
|February 28, 2020
Summary
Current evidence does not support a lactose-free diet for irritable bowel syndrome (IBS). Hydrogen breath testing may be a reasonable diagnostic step for IBS patients.
Area of Science:
- Gastroenterology
- Dietary Science
- Microbiome Research
Background:
- Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder significantly impacting quality of life.
- Pathophysiology of IBS remains poorly understood, complicating treatment strategies.
- Lactose-free diets are commonly recommended, yet evidence supporting this is limited.
Purpose of the Study:
- To evaluate the scientific literature for evidence supporting lactose-free diets in IBS management.
- To investigate potential links between IBS and malabsorption syndromes.
- To assess the efficacy of lactase supplementation for IBS.
Main Methods:
- Systematic review of articles from the PubMed database.
- Inclusion of studies from diverse geographic regions to enhance generalizability.
- Analysis of evidence regarding lactose malabsorption and IBS.
Main Results:
- While many IBS patients report milk intolerance, objective links to malabsorption syndromes are inconclusive.
- Lactase supplementation trials did not demonstrate clinical benefits for IBS patients.
- No conclusive evidence supports routine lactose-free diets for IBS.
Conclusions:
- Routine recommendation of lactose-free diets for IBS lacks sufficient evidence.
- Hydrogen breath testing is a reasonable consideration in the diagnostic workup of IBS.
- Further clinical trials and fecal chemical studies are necessary to elucidate IBS pathophysiology and inform dietary recommendations.
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