Gudmand-Høyer E
Division of Gastroenterology, Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark.
Am J Clin Nutr. 1994 Mar;59(3 Suppl):735S-741S. doi: 10.1093/ajcn/59.3.735S.
The prevalence of lactose maldigestion is lowest in Scandinavia and Northwest Europe (3-8%) and close to 100% in most of Southeast Asia. In Europe the frequency increases in the southern and eastern directions, reaching 70% in southern Italy and Turkey. There is also a high prevalence of lactose maldigestion in the people of Africa with the exception of cattle-raising nomads. Lactose maldigestion causes uncharacteristic abdominal symptoms such as bloating, borborygmus, colic, flatulence, and diarrhea. The degree of discomfort depends on the amount of lactose consumed, but also on an individual sensitivity to lactose. The symptoms of irritable bowel syndrome (IBS) and lactose maldigestion are similar. Consequently, most investigations indicate an increased frequency of lactose maldigestion in patients suffering from IBS. Recurrent abdominal pain (RAP) in children corresponds to IBS in adults. Lactose maldigestion is a frequent cause of RAP in regions with a high prevalence of lactose maldigestion in early childhood. Diffuse small-intestinal damage in celiac disease or kwashiorkor leads to a proportional decrease of all disaccharidase activities, with the most pronounced being decrease of lactase. The consumption of milk may then cause abdominal discomfort and increased diarrhea. Several investigations have indicated an increased frequency of lactose maldigestion in patients with osteoporosis. A connection between lactose maldigestion and decreased absorption of calcium has not been proven, however. The increased tendency toward osteoporosis is more likely caused by a lower calcium intake because of milk intolerance. Milk and dairy products with reduced lactose content are better tolerated by patients with lactose maldigestion.(ABSTRACT TRUNCATED AT 250 WORDS)
乳糖消化不良的患病率在斯堪的纳维亚半岛和西北欧最低（3%-8%），而在东南亚大部分地区接近100%。在欧洲，其发生率在南部和东部呈上升趋势，在意大利南部和土耳其达到70%。除了以畜牧为生的游牧民族外，非洲人群中乳糖消化不良的患病率也很高。乳糖消化不良会引发一些不典型的腹部症状，如腹胀、肠鸣、绞痛、肠胃胀气和腹泻。不适程度不仅取决于乳糖摄入量，还取决于个体对乳糖的敏感度。肠易激综合征（IBS）和乳糖消化不良的症状相似。因此，大多数调查表明，IBS患者中乳糖消化不良的发生率有所增加。儿童反复出现的腹痛（RAP）与成人的IBS相对应。在幼儿期乳糖消化不良患病率较高的地区，RAP的常见病因是乳糖消化不良。乳糜泻或夸希奥科病中弥漫性小肠损伤会导致所有双糖酶活性成比例下降，其中乳糖酶下降最为明显。饮用牛奶可能会导致腹部不适并加重腹泻。多项调查表明，骨质疏松症患者中乳糖消化不良的发生率有所增加。然而，乳糖消化不良与钙吸收减少之间的关联尚未得到证实。骨质疏松症倾向增加更可能是由于牛奶不耐受导致钙摄入量较低引起的。乳糖含量降低的牛奶和奶制品更容易被乳糖消化不良的患者耐受。（摘要截选至250词）
