RESUMO
INTRODUCTION: Some patients complain of digestive symptoms related to diary products intake. This intolerance could be associated with an intestinal bacterial overgrowth or an increased fermentative intestinal profile and not due to lactose malabsorption. OBJECTIVE: To estimate the prevalence of bacterial overgrowth in subjects with digestive symptoms related to diary products intolerance. MATERIAL AND METHODS: Patients who had performed hydrogen breath test due to chronic functional distension syndrome (Rome III) were analyzed. Thirty of them (22 female, average age 52 years) complained of symptoms related to diary products intake. All subjects completed a nutritional survey that allowed to assess the degree of tolerance to milk products and performed the hydrogen breath test with lactulose as substrate. Bacterial overgrowth was considered when baseline values were over 15 parts per million (ppm), values before 80 minutes were greater than 20 ppm or values of area under the curve were greater than 3,000 ppm/min in the 180 studied minutes. RESULTS: Fifty four patients were analyzed. Thirty of them showed moderate, important or severe clinical milk intolerance. Of these patients, 23 (77%), had a positive breath hydrogen test according to used criteria. CONCLUSIONS: The prevalence of small bowel bacterial overgrowth or an increased fermentative intestinal profile among individuals who complain of symptoms related to diary products is high and this fact should be considered in order to avoid empirical restrictive diets.
Assuntos
Bactérias/crescimento & desenvolvimento , Intestino Delgado/microbiologia , Intolerância à Lactose/microbiologia , Adulto , Idoso , Testes Respiratórios , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Índice de Gravidade de DoençaRESUMO
Lactose (milk sugar) is a fermentable substrate. It can be fermented outside of the body to produce cheeses, yoghurts and acidified milks. It can be fermented within the large intestine in those people who have insufficient expression of lactase enzyme on the intestinal mucosa to ferment this disaccharide to its absorbable, simple hexose sugars: glucose and galactose. In this way, the issues of lactose intolerance and of fermented foods are joined. It is only at the extremes of life, in infancy and old age, in which severe and life-threatening consequences from lactose maldigestion may occur. Fermentation as part of food processing can be used for preservation, for liberation of pre-digested nutrients, or to create ethanolic beverages. Almost all cultures and ethnic groups have developed some typical forms of fermented foods. Lessons from fermentation of non-dairy items may be applicable to fermentation of milk, and vice versa.
Assuntos
Laticínios/microbiologia , Intolerância à Lactose/microbiologia , Fermentação/fisiologia , HumanosRESUMO
Se hace una revisión de los primeros trabajos sobre intolerancia a la lactosa en niños con gastroenteritis realizados en México. En 1963 en el Hospital de Pediatría del Centro Médico Nacional del IMSS se investigó la presencia de azúcares reductoras en heces. En 1968 se establecieron pautas para el diagnóstico y tratamiento de la intolerancia a la lactosa en niños con gastroenteritis y se diseñaron fórmulas con harina de soya, carne de pollo y caseinato de calcio para sustituir la fórmula láctea. Se confirmó la utilidad de las cintas y tabletas reactivas y curvas de tolerancia a la lactosa en el diagnóstico de intolerancia a la lactosa en el diagnóstico de intolerancia a los carbohidratos. En 1979 se realizó por primera vez la determinación de hidrógeno espirado como prueba diagnóstica de intolerancia a la lactosa y se realizaron diversos estudios metabólicos, uno de ellos comparando proteínas de soya y garbanzo demostrándose igual valor nutricio. Se comenta sobre las ventajas de las fórmulas lácteas sin lactosa