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超越吸收不良:怀疑乳糖不耐症患者需要基于症状的评估. 从测试特定症状评估中吸取的经验教训
Johann Hammer1, Heinz F Hammer2
1Department of Gastroenterology and Hepatology, University Hospital of Internal Medicine 3, Medical University of Vienna, Vienna, Austria.
Neurogastroenterology and motility
|September 17, 2025
概括
乳糖吸收不良并不总是引起症状;许多患者在没有吸收不良的情况下经历了乳糖引起的症状. 综合性评估对于有效治疗胃肠道不适至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 消化系统健康 消化系统健康
- 肠-大脑相互作用
背景情况:
- 乳糖吸收不良通常被认为会导致胃肠道问题,但即使饮食改变或使用酶,症状也经常持续存在.
- 这突显了乳糖吸收不良和患者报告的症状之间的潜在断开.
研究的目的:
- 调查摄入乳糖症状与实际乳糖吸收不良之间的关系.
- 探索这些症状与果糖敏感性和肠-大脑相互作用 (DGBIs) 障碍的关联.
主要方法:
- 753名患有DGBI的患者接受了气呼吸测试,以确定乳糖吸收不良 (LM+).
- 成人碳水化合物感知问卷 (aCPQ) 和视觉模拟量表 (VAS) 评估了乳糖诱导的症状 (LS+).
- 在547名患者中,使用类似的协议评估了果糖敏感性.
主要成果:
- 乳糖吸收不良 (LM+) 在40.9%的患者中发生,而55.4%的患者报告了乳糖诱导症状 (LS+).
- 显著一部分症状患者 (45.3%) 没有乳糖吸收不良,吸收不良患者中有26.0%是无症状的.
- 有症状的患者 (LS+) 更有可能患上果糖敏感性 (45.2%对24.2%,p < 0.001).
- 功能性消化不良和刺激性肠综合征在LS+患者中更为普遍,无论吸收不良状态如何.
结论:
- 仅仅乳糖吸收不良就不足以预测症状的发生,需要在呼吸测试之外进行更广泛的症状评估.
- 研究结果表明,症状的发展中存在重叠机制和内脏过敏,特别是与同时存在的果糖敏感性.
- 这强调了个性化治疗策略对DGBI患者的重要性.
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