Milk tolerance in adults with ulcerative colitis

Area of Science:

• Gastroenterology
• Clinical Nutrition
• Inflammatory Bowel Disease Research

Background:

• Physicians and patients express concern that milk intolerance may exacerbate ulcerative colitis (UC) disease activity.
• Current clinical practice often involves recommending milk product avoidance for UC patients.
• The relationship between milk tolerance and UC activity requires clarification.

Purpose of the Study:

• To investigate the prevalence and significance of milk tolerance issues in patients diagnosed with ulcerative colitis.
• To determine if lactose intolerance is a contributing factor to disease activity or flares in UC.
• To assess physician and patient perceptions regarding milk consumption and UC.

Main Methods:

• A survey was distributed to gastroenterologists regarding their recommendations on milk product consumption for UC patients.
• Ulcerative colitis patients completed questionnaires about their milk ingestion habits and tolerance.
• Lactose hydrogen breath testing was performed on UC patients and matched controls to assess lactose intolerance, with dose adjustments for intolerant individuals.

Main Results:

• A high percentage of physicians (80%) advise milk product avoidance to their UC patients.
• Lactose intolerance prevalence was similar between UC patients (44%) and controls (36%), with no statistically significant difference (p = 0.57).
• Lactose intolerance was not more common during UC flares, and many patients avoiding milk products were not lactose intolerant, indicating a 35% discordance rate.

Conclusions:

• Misperceptions regarding lactose intolerance in ulcerative colitis are common among both physicians and patients.
• Lactose intolerance in UC patients is primarily influenced by age and ethnicity, not the disease itself.
• The study does not support the common practice of restricting milk products during UC flares.