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Lactose malabsorption after bypass operation for obesity

E Gudmand-Höyer, N G Asp, H Skovbjerg

    Scandinavian Journal of Gastroenterology
    |January 1, 1978
    PubMed
    Summary

    Bypass surgery for obesity significantly reduces lactose digestion. Many patients experience lactose intolerance and digestive issues post-operation due to decreased lactase activity in the intestinal shunt.

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    Area of Science:

    • Gastroenterology
    • Bariatric Surgery
    • Digestive Physiology

    Background:

    • Obesity surgery, particularly bypass procedures, can alter gastrointestinal anatomy and function.
    • Lactose intolerance is a common condition characterized by the inability to fully digest lactose, a sugar found in milk.
    • Lactase is the enzyme responsible for hydrolyzing lactose.

    Purpose of the Study:

    • To investigate the impact of obesity bypass surgery on residual lactose-hydrolyzing capacity.
    • To assess the incidence of lactose intolerance and related symptoms in patients following bypass surgery.
    • To determine if lactase activity is a limiting factor in postoperative lactose absorption.

    Main Methods:

    • Analysis of lactose-hydrolyzing capacity in the functioning shunt after obesity bypass surgery.
    • Evaluation of patient-reported symptoms, including diarrhea and milk intolerance, post-surgery.
    • Oral glucose tolerance tests to assess lactase activity and its role in lactose absorption.

    Main Results:

    • Reduced lactose-hydrolyzing capacity was observed in the shunt, particularly with shorter jejunal segments.
    • A temporary decrease in jejunal lactase activity was noted in the initial postoperative months.
    • Lactose intake provoked or worsened symptoms in 20 out of 33 patients; 10 reported milk intolerance.
    • Oral glucose tolerance tests confirmed lactase activity as rate-limiting for lactose absorption.

    Conclusions:

    • Obesity bypass surgery significantly impairs the digestive capacity for lactose.
    • Postoperative lactose intolerance is a frequent complication, linked to reduced lactase activity in the intestinal shunt.
    • Lactase deficiency is a key factor contributing to malabsorption and symptoms after bypass surgery.

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