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A CONFERENCE REPORT
Group 3 – Section A2
UDP-
glucose-4-
epimerase
UDP-Glucose
galactosyltransferase
DIGESTION, ABSORPTION AND
UTILIZATION OF LACTOSE
PATHOPHYSIOLOGY of Lactose Intolerance
Primary Adult
Lactase Deficiency
Advantages:
o Gives definitive diagnosis
o Secondary causes of lactase deficiency (e.g. sprue) can be detected
Advantage:
o direct test for lactase deficiency
Disadvantage:
o Use of specialized procedures not always available
o Most invasive
o Used for research purposes only
HYDROGEN BREATH TEST
Based on the metabolism of undigested lactose by colonic
bacteria
Amount of H2 or methane excreted in the breath is
roughly proportional to the degree of lactase deficiency.
However, it is not proportional to the severity of
symptoms
Normal result: less than 12 ppm over fasting level
Positive result: more than or equal to 20ppm after 1 hour of oral
lactose dose
o After 6 hours, sensitivity is increased by 40-60%
Advantage:
o A convenient, non-invasive, cost-effective, and reliable test
o Efficacy:
Preferred over Lactose Tolerance Test
Efficacy:
False positive result: 20%
False negative result: 20%
TO CONFIRM POSITIVE RESULT…
Repeat the test after patient drink an aqueous solution
containing half of carbohydrate dose as glucose and half as
galactose
Disadvantages:
Needs ethanol (alcohol) ingestion
STOOL ACIDITY TEST
Required for clinical diagnosis
Not specific but is a helpful marker for lactose (or CHO)
malabsorption
Is usually combined with analysis for presence of reducing sugars
(lactose, glucose, galactose, and fructose) in the stool
Normal: alkaline (7.0 – 8.0)
Positive result: pH less than 5.6
presence of reducing sugar in stool
Due to Lactic Acid, a fermentation product of bacterial digestion of
unabsorbed lactose
Advantage:
Used in infants and young children
Disadvantage:
Results cannot form a definitive diagnosis of Lactose Intolerance
No nausea or vomiting
4. Hypothroidism or hyperthroidism
6. Lactose intolerance
7. Hypolactasia
MANAGEMENT OF LACTOSE
INTOLERANCE
DIETARY CHANGES
– REDUCTION OF LACTOSE IN THE DIET
LACTASE ENZYME
ADAPTATION
- INGESTION OF ANY MILK CONTAINING FOODS DURING
MEAL