04.03.2005, 21:37
2 Artikel über Reizdarm, vom „Nachbarn“ Holland – in englischer Spache
Eur J Gastroenterol Hepatol. 1996 Oct;8(10):1013-6.
·
The clinical relevance of lactose malabsorption in irritable bowel syndrome.
Bohmer CJ, Tuynman HA.
Department of Gastroenterology, Academical Hospital Free University, Amsterdam, The Netherlands.
OBJECTIVE: The prevalence of lactose malabsorption (LM) in the Caucasian population of northern Europe is estimated to be low. Irritable bowel syndrome (IBS) is a very common diagnosis, and its symptoms are nearly identical to those of LM. Therefore we investigated the prevalence of LM among IBS patients in comparison with healthy volunteers. DESIGN: A double-blind clinical trial compared with healthy controls. SETTING: One out-patient gastroenterology clinic in the Netherlands. PATIENTS: 70 Caucasian IBS patients and 35 healthy volunteers (staff members). METHODS: All 105 underwent hydrogen (H2) breath and blood glucose tests, after an oral intake of 50 grams of lactose. The IBS patients were treated with a lactose-restricted diet for 6 weeks. They completed a lactose intake score before, and a symptom score scored by six separate criteria, before, during and after treatment. RESULTS: In 17 out of 70 (24.3%) IBS patients LM was detected, in comparison with 2 out of 35 (5.7%) controls (P < 0.009). There was no difference in the pre-entry mean lactose intake and symptom score between the LM positive and negative IBS patients. The mean symptom score of the LM positive group showed a marked decrease after 6 weeks of dietary therapy (P < 0.001). CONCLUSION: A substantial number of IBS patients showed a clinically unrecognized lactose malabsorption, which could not be discriminated by symptoms and dietary history, and which can be treated with a lactose-restricted diet. Therefore LM has to be excluded before the diagnosis IBS is made.
PMID: 8930569 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query...ds=8930569
na- und hier die Folge-Studie – 5 Jahre später!
Eur J Gastroenterol Hepatol. 2001 Aug;13(8):941-4.
The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: a 5-year follow-up study.
Bohmer CJ, Tuynman HA.
Department of Gastroenterology, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands. CJM.Bohmer@azvu.nl
DESIGN AND METHODS: Prospectively, the effect of a lactose-restricted diet was evaluated among irritable bowel syndrome patients with lactose malabsorption. Lactose malabsorption was defined by a positive hydrogen breath test and a positive blood-glucose test. An analysis of symptoms was completed before, during, 6 weeks after and 5 years after starting the diet. In addition, the number of visits made by the patients to the outpatient clinic was scored during 6 years. RESULTS: In 17 out of 70 irritable bowel syndrome patients (24.3%), lactose malabsorption was detected. There was no difference in the symptom score between patients with a positive lactose tolerance test and patients with a negative lactose tolerance test. After 6 weeks of the lactose-restricted diet, symptoms were markedly improved in lactose malabsorption-positive patients (P < 0.001). After 5 years, one patient was lost for follow-up, and 14 out of the remaining 16 lactose malabsorption patients (87.5%) still had no complaints during the lactose-restricted diet. Two patients chose not to follow the diet continuously and accepted the discomfort caused by lactose intake. Only two out of 16 patients (12.5%) no longer experienced any benefit from lactose restriction. In the 5 years before their diagnosis of lactose malabsorption, these 16 patients visited the outpatient clinic a total of 192 times (mean 2.4 visits per year per person; range 1-7 visits). In the 5 years after diagnosis, they visited the outpatient clinic a total of 45 times (mean 0.6 visits per year per person; range 0-6 visits; P < 0.0001). CONCLUSIONS: In a large majority of irritable bowel syndrome patients with lactose malabsorption, which was previously clinically unrecognized, a lactose-restricted diet improved symptoms markedly both in the short term and the long term. Furthermore, visits by all patients to the outpatient clinic were reduced by 75%. We conclude that diet therapy is extremely cost- and time-saving. Therefore, it is strongly recommended that lactose malabsorption, which is easily treatable, is excluded before diagnosing irritable bowel syndrome .
PMID: 11507359 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query...s=11507359
Das Fazit dieser 2 Studien:
Eine große Mehrheit der Reizdarm-Patienten hatte eine unerkannte Laktose-Intoleranz.
Eine laktosereduzierte Diät führte zu einer bemerkenswerten Besserung der Symptome – sowohl bei der Kurzzeitbeobachtung als auch bei der Langzeitbeobachtung.
Arzt-/Klinikbesuche reduzierten sich um 75%.
Abschließend kann festgestellt werden, dass die Ernährungstherapie extrem kosten – und zeitsparend ist. Aus diesem Grunde wird dringend empfohlen, dass vor der Diagnosestellung >>Reizdarm<< eine Laktosemalabsorption , die einfach zu „behandeln“ ist, auszuschließen ist!
Eine israelische Studie erweitert die Kohlenhydratmalabsorption noch um Fruktose und Sorbit:
1: Isr Med Assoc J. 2000 Aug;2(8):583-7
Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints.
Goldstein R, Braverman D, Stankiewicz H.
PMID: 10979349 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query...s=10979349
Und ich bin so frei und fordere dazu auf, auch noch an die anderen Möglichkeiten einen Gedanken zu „verschwenden“- als da wären Unverträglichkeiten auf Nahrungsproteine, Pseudoallergien, Histaminose und Kreuzallergien ......
Uli
Eur J Gastroenterol Hepatol. 1996 Oct;8(10):1013-6.
·
The clinical relevance of lactose malabsorption in irritable bowel syndrome.
Bohmer CJ, Tuynman HA.
Department of Gastroenterology, Academical Hospital Free University, Amsterdam, The Netherlands.
OBJECTIVE: The prevalence of lactose malabsorption (LM) in the Caucasian population of northern Europe is estimated to be low. Irritable bowel syndrome (IBS) is a very common diagnosis, and its symptoms are nearly identical to those of LM. Therefore we investigated the prevalence of LM among IBS patients in comparison with healthy volunteers. DESIGN: A double-blind clinical trial compared with healthy controls. SETTING: One out-patient gastroenterology clinic in the Netherlands. PATIENTS: 70 Caucasian IBS patients and 35 healthy volunteers (staff members). METHODS: All 105 underwent hydrogen (H2) breath and blood glucose tests, after an oral intake of 50 grams of lactose. The IBS patients were treated with a lactose-restricted diet for 6 weeks. They completed a lactose intake score before, and a symptom score scored by six separate criteria, before, during and after treatment. RESULTS: In 17 out of 70 (24.3%) IBS patients LM was detected, in comparison with 2 out of 35 (5.7%) controls (P < 0.009). There was no difference in the pre-entry mean lactose intake and symptom score between the LM positive and negative IBS patients. The mean symptom score of the LM positive group showed a marked decrease after 6 weeks of dietary therapy (P < 0.001). CONCLUSION: A substantial number of IBS patients showed a clinically unrecognized lactose malabsorption, which could not be discriminated by symptoms and dietary history, and which can be treated with a lactose-restricted diet. Therefore LM has to be excluded before the diagnosis IBS is made.
PMID: 8930569 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query...ds=8930569
na- und hier die Folge-Studie – 5 Jahre später!
Eur J Gastroenterol Hepatol. 2001 Aug;13(8):941-4.
The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: a 5-year follow-up study.
Bohmer CJ, Tuynman HA.
Department of Gastroenterology, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands. CJM.Bohmer@azvu.nl
DESIGN AND METHODS: Prospectively, the effect of a lactose-restricted diet was evaluated among irritable bowel syndrome patients with lactose malabsorption. Lactose malabsorption was defined by a positive hydrogen breath test and a positive blood-glucose test. An analysis of symptoms was completed before, during, 6 weeks after and 5 years after starting the diet. In addition, the number of visits made by the patients to the outpatient clinic was scored during 6 years. RESULTS: In 17 out of 70 irritable bowel syndrome patients (24.3%), lactose malabsorption was detected. There was no difference in the symptom score between patients with a positive lactose tolerance test and patients with a negative lactose tolerance test. After 6 weeks of the lactose-restricted diet, symptoms were markedly improved in lactose malabsorption-positive patients (P < 0.001). After 5 years, one patient was lost for follow-up, and 14 out of the remaining 16 lactose malabsorption patients (87.5%) still had no complaints during the lactose-restricted diet. Two patients chose not to follow the diet continuously and accepted the discomfort caused by lactose intake. Only two out of 16 patients (12.5%) no longer experienced any benefit from lactose restriction. In the 5 years before their diagnosis of lactose malabsorption, these 16 patients visited the outpatient clinic a total of 192 times (mean 2.4 visits per year per person; range 1-7 visits). In the 5 years after diagnosis, they visited the outpatient clinic a total of 45 times (mean 0.6 visits per year per person; range 0-6 visits; P < 0.0001). CONCLUSIONS: In a large majority of irritable bowel syndrome patients with lactose malabsorption, which was previously clinically unrecognized, a lactose-restricted diet improved symptoms markedly both in the short term and the long term. Furthermore, visits by all patients to the outpatient clinic were reduced by 75%. We conclude that diet therapy is extremely cost- and time-saving. Therefore, it is strongly recommended that lactose malabsorption, which is easily treatable, is excluded before diagnosing irritable bowel syndrome .
PMID: 11507359 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query...s=11507359
Das Fazit dieser 2 Studien:
Eine große Mehrheit der Reizdarm-Patienten hatte eine unerkannte Laktose-Intoleranz.
Eine laktosereduzierte Diät führte zu einer bemerkenswerten Besserung der Symptome – sowohl bei der Kurzzeitbeobachtung als auch bei der Langzeitbeobachtung.
Arzt-/Klinikbesuche reduzierten sich um 75%.
Abschließend kann festgestellt werden, dass die Ernährungstherapie extrem kosten – und zeitsparend ist. Aus diesem Grunde wird dringend empfohlen, dass vor der Diagnosestellung >>Reizdarm<< eine Laktosemalabsorption , die einfach zu „behandeln“ ist, auszuschließen ist!
Eine israelische Studie erweitert die Kohlenhydratmalabsorption noch um Fruktose und Sorbit:
1: Isr Med Assoc J. 2000 Aug;2(8):583-7
Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints.
Goldstein R, Braverman D, Stankiewicz H.
PMID: 10979349 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query...s=10979349
Und ich bin so frei und fordere dazu auf, auch noch an die anderen Möglichkeiten einen Gedanken zu „verschwenden“- als da wären Unverträglichkeiten auf Nahrungsproteine, Pseudoallergien, Histaminose und Kreuzallergien ......
Uli