Review
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World J Gastroenterol. Jan 14, 2006; 12(2): 187-191
Published online Jan 14, 2006. doi: 10.3748/wjg.v12.i2.187
Management and treatment of lactose malabsorption
Massimo Montalto, Valentina Curigliano, Luca Santoro, Monica Vastola, Giovanni Cammarota, Raffaele Manna, Antonio Gasbarrini, Giovanni Gasbarrini
Massimo Montalto, Valentina Curigliano, Luca Santoro, Monica Vastola, Giovanni Cammarota, Raffaele Manna, Antonio Gasbarrini, Giovanni Gasbarrini, Department of Internal Medicine, Catholic University, Rome, Italy
Correspondence to: Dr. Massimo Montalto, Istituto di Medicina Interna, Università Cattolica del Sacro Cuore, Largo Gemelli, 8 - 00168 Roma, Italia. mmontalto@rm.unicatt.it
Telephone: +39 (0)6 30154334 Fax: +39 (0)6 35502775
Received: May 23, 2005
Revised: June 28, 2005
Accepted: July 15, 2005
Published online: January 14, 2006
Abstract

Lactose malabsorption is a very common condition characterized by intestinal lactase deficiency. Primary lactose malabsorption is an inherited deficit present in the majority of the world’s population, while secondary hypolactasia can be the consequence of an intestinal disease. The presence of malabsorbed lactose in the colonic lumen causes gastrointestinal symptoms. The condition is known as lactose intolerance. In patients with lactase nonpersistence, treatment should be considered exclusively if intolerance symptoms are present. In the absence of guidelines, the common therapeutic approach tends to exclude milk and dairy products from the diet. However, this strategy may have serious nutritional disadvantages. Several studies have been carried out to find alternative approaches, such as exogenous β-galactosidase, yogurt and probiotics for their bacterial lactase activity, pharmacological and non pharmacological strategies that can prolong contact time between enzyme and substrate delaying gastrointestinal transit time, and chronic lactose ingestion to enhance colonic adaptation. In this review the usefulness of these approaches is discussed and a therapeutic management with a flow chart is proposed.

Keywords: Lactose; Malabsorption; Intolerance; Therapy