Milk consumption, symptom response, and lactose digestion in milk intolerance

The experience of adverse gastrointestinal symptoms (gas, abdominal pain, and diarrhea) after the oral ingestion of 360 mL whole milk was investigated in 25 adults who claimed to be milk intolerant. The level of customary milk consumption by all subjects was low compared with that of 13 control subjects who denied a history of milk intolerance. After drinking the milk, which was accompanied by a hydrogen breath test, most of the subjects experienced some of their accustomed intestinal discomfort and the degree of intolerance was similar for the nine (36%) who proved to be true lactose-maldigester subjects and the 16 (64%) who had flat hydrogen breath responses, ie, who were classified as lactose-digester subjects. There is a subpopulation of lactose-intolerant milk-rejector individuals that absorbs lactose efficiently and responds to other milk-related factor(s) with the same subjective symptoms and dietary conduct as do true lactose-maldigester individuals.