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乳糖消化不良、吸收不良和不耐受:全面综述,重点关注当前管理和未来展望。

Lactose Maldigestion, Malabsorption, and Intolerance: A Comprehensive Review with a Focus on Current Management and Future Perspectives.

机构信息

Allergy and Clinical Immunology Unit, Azienda Usl Toscana Centro, Ospedale San Giovanni di Dio, 50143 Firenze, Italy.

AILI-Associazione Italiana Latto-Intolleranti Onlus, 55100 Lucca, Italy.

出版信息

Nutrients. 2018 Nov 1;10(11):1599. doi: 10.3390/nu10111599.

Abstract

Milk is a fundamental component of the diet of every mammal; nevertheless, not every individual can tolerate this kind of food, especially in adulthood. However, lactose intolerance has only been recognized in the last 50 years, and currently, lactose intolerance is defined as a clinical syndrome characterized by pain, abdominal distention, flatulence, and diarrhoea that occur after lactose consumption. Lactose is currently a common disaccharide in human nutrition, both in breastfed infants and in adults, but its digestion requires a specialized enzyme called lactase. The genetically programmed reduction in lactase activity during adulthood affects most of the world's adult population and can cause troublesome digestive symptoms, which may also vary depending on the amount of residual lactase activity; the small bowel transit time; and, especially, the amount of ingested lactose. Several diagnostic tests are currently available for lactose intolerance, but the diagnosis remains challenging. The treatment for lactose intolerance mainly consists of reducing or eliminating the dietetic amount of lactose until the symptoms disappear, but this is hard to achieve, as lactose is present in dairy products and is even commonly used as a food additive. In addition to dietetic restriction of lactose-containing foods, lactase can be administered as an enzymatic food supplement, but its efficacy is still controversial. Recently, probiotics have been proposed for the management of lactose intolerance; certain probiotic strains have shown specific β-galactosidase activity, thus aiding in the digestion of lactose. The aim of this paper was to review the current knowledge about lactose intolerance and to discuss the potential for the use of specific probiotic strains such as dietary supplements in lactose-intolerant patients.

摘要

牛奶是所有哺乳动物饮食的基本组成部分;然而,并非每个人都能耐受这种食物,尤其是在成年后。然而,乳糖不耐受症仅在过去 50 年才被认识到,目前,乳糖不耐受症被定义为一种临床综合征,其特征是在摄入乳糖后出现疼痛、腹胀、气胀和腹泻。乳糖目前是人类营养中的一种常见二糖,无论是在母乳喂养的婴儿还是在成年人中,但它的消化需要一种名为乳糖酶的特殊酶。成年期乳糖酶活性的基因编程减少影响了世界上大多数成年人口,并可能导致麻烦的消化症状,这些症状也可能因残余乳糖酶活性的多少、小肠转运时间以及摄入的乳糖量而异。目前有几种用于乳糖不耐受症的诊断测试,但诊断仍然具有挑战性。乳糖不耐受症的治疗主要包括减少或消除饮食中的乳糖量,直到症状消失,但这很难做到,因为乳糖存在于乳制品中,甚至常用于食品添加剂。除了饮食限制含乳糖的食物外,还可以服用乳糖酶作为酶类食品补充剂,但它的疗效仍存在争议。最近,益生菌被提议用于管理乳糖不耐受症;某些益生菌株具有特定的β-半乳糖苷酶活性,从而有助于乳糖的消化。本文旨在综述乳糖不耐受症的最新知识,并讨论特定益生菌株(如膳食补充剂)在乳糖不耐受患者中的应用潜力。

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