Matthews S B, Waud J P, Roberts A G, Campbell A K
Department of Medical Biochemistry and Immunology, Llandough Hospital, Cardiff and Vale NHS Trust, Penarth Vale of Glamorgan, UK.
Postgrad Med J. 2005 Mar;81(953):167-73. doi: 10.1136/pgmj.2004.025551.
Intolerance to certain foods can cause a range of gut and systemic symptoms. The possibility that these can be caused by lactose has been missed because of "hidden" lactose added to many foods and drinks inadequately labelled, confusing diagnosis based on dietary removal of dairy foods. Two polymorphisms, C/T13910 and G/A22018, linked to hypolactasia, correlate with breath hydrogen and symptoms after lactose. This, with a 48 hour record of gut and systemic symptoms and a six hour breath hydrogen test, provides a new approach to the clinical management of lactose intolerance. The key is the prolonged effect of dietary removal of lactose. Patients diagnosed as lactose intolerant must be advised of "risk" foods, inadequately labelled, including processed meats, bread, cake mixes, soft drinks, and lagers. This review highlights the wide range of systemic symptoms caused by lactose intolerance. This has important implications for the management of irritable bowel syndrome, and for doctors of many specialties.
对某些食物不耐受会引发一系列肠道和全身症状。由于许多食品和饮料中添加了“隐藏”乳糖且标签标注不充分，导致人们忽略了这些症状可能由乳糖引起，这使得基于去除乳制品饮食的诊断变得混乱。与乳糖酶缺乏相关的两种多态性，即C/T13910和G/A22018，与乳糖摄入后的呼气氢含量及症状相关。结合48小时的肠道和全身症状记录以及6小时的呼气氢测试，为乳糖不耐受的临床管理提供了一种新方法。关键在于去除饮食中乳糖的长期效果。必须告知被诊断为乳糖不耐受的患者注意那些标签标注不充分的“风险”食物，包括加工肉类、面包、蛋糕预拌粉、软饮料和啤酒。这篇综述强调了乳糖不耐受引发的广泛全身症状。这对肠易激综合征的管理以及许多专科医生都具有重要意义。
