Effective management for lactose intolerance is uncertain

January 01, 0001

Effective management for lactose intolerance is uncertain

These US authors assessed the maximum tolerable dose of lactose and interventions for reducing symptoms of lactose intolerance among persons with lactose intolerance and malabsorption I a systematic review of the literature.

They found: "36 unique randomized studies (26 on lactase- or lactose- hydrolyzed milk supplements, lactose-reduced milk, or tolerable doses of lactose; 7 on probiotics; 2 on incremental lactose administration for colonic adaptation; and 1 on another agent) met inclusion criteria. Moderate-quality evidence indicated that 12 to 15 g of lactose (approximately 1 cup of milk) is well tolerated by most adults. Evidence was insufficient that lactose-reduced solution or milk with a lactose content of 0 to 2 g, compared with greater than 12 g, is effective in reducing symptoms of lactose intolerance. Evidence for probiotics, colonic adaptation, and other agents was also insufficient."

The authors concluded: "Most individuals with presumed lactose intolerance or malabsorption can tolerate 12 to 15 g of lactose. Additional studies are needed to determine the effectiveness of lactose intolerance treatment."

The bottom line here seems to be that most approaches to managing lactose intolerance are of unproven benefit.

For the full abstract, click here.

Annals of Internal Medicine 152(12):797-803, 15 June 2010
© 2010 to the American College of Physicians
Systematic Review: Effective Management Strategies for Lactose Intolerance. Aasma Shaukat, Michael D. Levitt, Brent C. Taylor, et al. Correspondence to Dr. Wilt: [email protected]

Category: D. Digestive. Keywords: lactose intolerance, milk, adults, systematic review of randomized trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 29 June 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.