Breath hydrogen concentrations after oral lactose and lactulose in tropical malabsorption and adult hypolactasia.

Thirty-six hospital in-patients in London had breath-hydrogen concentrations measured after 50 g lactose were given orally; in 23 or them serial blood glucose concentrations were also estimated. Eight had tropical malabsorption (TM), 14 were Europeans with no detectable disease (normal group) and 14 who also had no detectable disease, were from ethnic groups known to have a very high incidence of genetically determined adult hypolactasia (hl). In 21 of them breath-hydrogen concentrations were also measured after 33.5 g of lactulose were given orally. There was a good inverse correlation between breath-hydrogen production and blood-glucose rise after lactose. Correlations between the first appearance of hydrogen (T) and the area under the hydrogen curve between 0 and 120 min (A) were inversely significant both for lactose and lactulose. Mean T was earlier and mean A greater for lactose compared with lactulose. Correlation between individual values for A after lactase and after lactulose was significant. Indirect measurements of lactase are of no value in either detecting or assessing the severity of TM; that is largely due to the very high incidence of HL in individuals exposed to that disease.