Vesa T H, Seppo L M, Marteau P R, Sahi T, Korpela R
Department of Biochemistry and Food Chemistry, University of Turku, Finland.
Am J Clin Nutr. 1998 Apr;67(4):710-5. doi: 10.1093/ajcn/67.4.710.
It has been suggested that the symptoms of irritable bowel syndrome (IBS) may be wrongly attributed to lactose intolerance. We examined the relations among IBS, demographic factors, living habits, and lactose intolerance. On the basis of a lactose tolerance test with ethanol, 101 of the 427 healthy subjects studied were lactose maldigesters and 326 were lactose digesters. IBS was diagnosed by means of the Bowel Disease Questionnaire, according to the Rome criteria. The use of dairy products and symptoms experienced after their consumption were recorded. IBS was found in 15% of both the lactose maldigesters and lactose digesters. One-third of the subjects reported intolerance to dairy products containing < or = 20 g lactose. About half of this third were lactose maldigesters and about half were lactose digesters. As explanations for this subjective lactose intolerance, the logistic regression model estimated lactose maldigestion (odds ratio: 10.3; 95% CI: 5.2, 20.4), IBS (4.6; 2.1, 10.1), experience of symptoms other than gastrointestinal ones (2.3; 1.2, 4.5), and female sex (2.1; 1.1, 4.0). Characteristics common to both subjective lactose intolerance and IBS were female sex and the experience of abdominal pain in childhood (P < 0.01). Age, regularity of meals, and the amount of physical activity were not associated with either subjective lactose intolerance or IBS. Of the subjects with IBS, the percentage of lactose maldigesters was the same as in the whole study group (24%) but the number who reported lactose intolerance was higher (60% compared with 27%, P < 0.001). We showed a strong relation among subjective lactose intolerance, IBS, the experience of abdominal pain in childhood, and female sex.
有人提出，肠易激综合征（IBS）的症状可能被错误地归因于乳糖不耐受。我们研究了IBS、人口统计学因素、生活习惯和乳糖不耐受之间的关系。在一项含乙醇的乳糖耐量试验的基础上，427名健康受试者中有101名乳糖消化不良者，326名乳糖消化者。根据罗马标准，通过肠道疾病问卷诊断IBS。记录乳制品的食用情况及其食用后出现的症状。乳糖消化不良者和乳糖消化者中IBS的发生率均为15%。三分之一的受试者报告对乳糖含量≤20克的乳制品不耐受。这三分之一受试者中约一半是乳糖消化不良者，约一半是乳糖消化者。作为对这种主观乳糖不耐受的解释，逻辑回归模型估计乳糖消化不良（比值比：10.3；95%可信区间：5.2，20.4）、IBS（4.6；2.1，10.1）、胃肠道以外症状的经历（2.3；1.2，4.5）和女性（2.1；1.1，4.0）。主观乳糖不耐受和IBS的共同特征是女性和童年时腹痛的经历（P<0.01）。年龄、进餐规律和体力活动量与主观乳糖不耐受或IBS均无关联。在患有IBS的受试者中，乳糖消化不良者的百分比与整个研究组相同（24%），但报告乳糖不耐受的人数更高（60%，而整个研究组为27%，P<0.001）。我们发现主观乳糖不耐受、IBS、童年时腹痛的经历和女性之间存在密切关系。
