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Ibuprofen augments gastrointestinal symptoms in lactose maldigesters during a lactose tolerance test
Author(s) -
Katri Peuhkuri,
Riikka Nevala,
Heikki Vapaatalo,
Eeva Moilanen,
Riitta Korpela
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00608.x
Subject(s) - lactose , ibuprofen , flatulence , medicine , nitric oxide , prostaglandin , crossover study , urine , urinary system , excretion , endocrinology , pharmacology , chemistry , biochemistry , placebo , alternative medicine , pathology
Background : Clinical symptoms during lactose tolerance test mimic those seen after therapeutic administration of prostaglandins, and resemble inflammatory processes. Aim : To investigate the possibility that lactose‐induced gastrointestinal symptoms are associated with prostaglandins and/or nitric oxide. Methods : After an overnight fast, nine maldigesters ingested lactose or sucrose with or without an inhibitor of prostaglandin synthesis (ibuprofen), in a randomised double‐blind crossover trial. Gastrointestinal symptoms, concentrations of PGE 2 ‐M in blood and urine, and urinary 6‐keto PGF 1α (as indicators of prostaglandin synthesis), and urinary nitrate and nitrite as well as cyclic GMP excretions (as indicators of nitric oxide formation), were measured. Results : Ibuprofen increased the first 3‐h symptom scores (flatulence + borborygmi + abdominal bloating + pain) caused by lactose ( P =0.008) but not sucrose. The concentrations of PGE 2 ‐M in the plasma and in the urine were unaffected. Lactose increased the urinary excretion of 6‐keto PGF 1α by about 30% ( P =0.17), which was inhibited by ibuprofen ( P =0.02). The production of nitric oxide was unaffected by lactose or ibuprofen. Conclusion : The inhibition of prostaglandin synthesis intensified gastrointestinal symptoms in lactose maldigesters, suggesting a negligible role for prostanoids in lactose‐induced symptoms.