Borralho Ana Isabel, Marcos Pedro
Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
Department of Gastroenterology, Pêro da Covilhã Hospital, Covilhã, Portugal.
GE Port J Gastroenterol. 2025 Apr 21:1-8. doi: 10.1159/000545923.
Lactose intolerance (LI) is a condition in which the consumption of lactose-containing products leads to gastrointestinal symptoms. Despite being a common digestive disorder worldwide, LI is often overlooked, and there are few established recommendations for its diagnosis and management. This review aims to provide a comprehensive overview of LI, focusing on its clinical features, diagnostic evaluation, and management strategies.
A review of literature published from 2013 to 2023 on PubMed was conducted. Systematic reviews, meta-analyses, randomized controlled trials, case-control studies, cohort studies, and expert reviews were prioritized for analysis. LI is a common condition that shares symptoms with several other diseases. Various diagnostic tests are available to identify LI, including hydrogen breath test (HBT), lactose tolerance test, urinary galactose test, gaxilose test, rapid lactase test, and genetic testing. Managing LI may involve adopting a lactose-free or low-lactose diet, taking oral enzyme supplements, using probiotics and prebiotics, or consuming plant-based alternative beverages.
LI affects many people worldwide and can significantly impact their quality of life. The HBT is the most widely used and effective method for diagnosing LI, along with a thorough assessment of symptoms. Instead of following a completely dairy-free diet, adopting a low-lactose diet - allowing up to 12-15 g of lactose per day - has been shown to be well tolerated and beneficial for most individuals with LI. While probiotics, prebiotics, and plant-based beverages may be helpful, their effectiveness in managing LI has not yet been proven.
乳糖不耐受（LI）是一种因食用含乳糖产品而导致胃肠道症状的病症。尽管LI是全球常见的消化系统疾病，但它常常被忽视，并且对于其诊断和管理几乎没有既定的建议。本综述旨在全面概述LI，重点关注其临床特征、诊断评估和管理策略。
对2013年至2023年在PubMed上发表的文献进行了综述。优先分析系统评价、荟萃分析、随机对照试验、病例对照研究、队列研究和专家综述。LI是一种常见病症，与其他几种疾病有共同症状。有多种诊断测试可用于识别LI，包括氢呼气试验（HBT）、乳糖耐量试验、尿半乳糖试验、加西洛糖试验、快速乳糖酶试验和基因检测。管理LI可能包括采用无乳糖或低乳糖饮食、口服酶补充剂、使用益生菌和益生元，或饮用植物性替代饮料。
LI影响着全球许多人，并会显著影响他们的生活质量。HBT是诊断LI最广泛使用且有效的方法，同时要对症状进行全面评估。对于大多数LI患者而言，采用低乳糖饮食（每天允许摄入多达12 - 15克乳糖）已被证明耐受性良好且有益，而不是遵循完全不含乳制品的饮食。虽然益生菌、益生元和植物性饮料可能会有所帮助，但它们在管理LI方面的有效性尚未得到证实。
