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Beneficial effects of oral tilactase on patients with hypolactasia
Author(s) -
Portincasa P.,
Di Ciaula A.,
Vacca M.,
Montelli R.,
Wang D. Q.H.,
Palasciano G.
Publication year - 2008
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.2008.02035.x
Subject(s) - lactulose , ingestion , lactose , breath test , bloating , gastroenterology , medicine , placebo , lactase , flatulence , excretion , malabsorption , lactose intolerance , abdominal pain , food science , chemistry , pathology , helicobacter pylori , alternative medicine
Background A lactose‐free diet is commonly prescribed to subjects with hypolactasia. We tested the effectiveness of a single ingestion of tilactase (a β‐ d ‐galactosidase from Aspergillus oryzae ) in adults with hypolactasia, previously assessed by lactose H 2 ‐breath test. Materials and methods After measurement of orocecal transit time (OCTT, by lactulose H 2 ‐breath test) and lactose H 2 ‐breath testing plus placebo, a total of 134 subjects were positive to hypolactasia and underwent lactose H 2 ‐breath testing plus either low (6750 U) or standard (11 250 U) doses of tilactase. The appearance of gastrointestinal symptoms during the tests was monitored. Results OCTT was longer in malabsorbers (subjects without bloating, abdominal pain and/or diarrhoea, n = 25) than in intolerants (bloating, abdominal pain and/or diarrhoea, n = 109, P < 0·02). Malabsorbers had longer time to H 2 peak ( P < 0·03), lower H 2 peak levels ( P < 0·002) and smaller integrated H 2 excretion levels ( P < 0·005) than intolerants. After tilactase ingestion, integrated H 2 levels were decreased by 75% (low dose) and 87% (standard dose) in malabsorbers, and by 74% (low dose) and 88% (standard dose) in intolerants. In the latter group, total symptom score were decreased by 76% (low dose) and by 88% (standard dose) ( P < 0·0001). Conclusion A single oral administration of tilactase is highly effective in decreasing symptoms and hydrogen excretion of hypolactasia assessed by lactose H 2 ‐breath test. If confirmed by long‐term observations, ingestion of tilactase might be a better option than exclusion diets in intolerant subjects with hypolactasia.