In a recent study, it was shown that a large proportion of patients with lactose malabsorption and with no bacterial overgrowth are affected by silent celiac disease.
Dr Veronica Ojetti and colleagues evaluated the effect of a gluten-free diet on lactose malabsorption.
The research team assessed malabsorption using the hydrogen lactose breath test and also the relationship with normalization of duodenal biopsies in celiac patients.
|Lactose breath test normalization in 64% after 12 months|
|Scandinavian Journal of Gastroenterology|
The team enrolled 15 patients affected by celiac disease with a positive lactose breath test and negative glucose breath test.
All were started on a gluten-free diet and were re-evaluated after 6 months by lactose breath test.
After 12 months, the team re-evaluated the patients by both lactose breath test and upper gastrointestinal endoscopy with biopsies.
The researchers observed lactose breath test normalization in 7% patients after 6 months, and in 64% of the remaining patients after 12 months.
The team found that the duodenal biopsies showed normal villi in 8 patients, partial villous atrophy in 5, and total atrophy in 2.
Dr Ojetti's team concluded, "The present study shows that a large proportion of celiac disease patients experience a regression of lactose malabsorption after receiving a gluten-free diet."
"This may be related to normalization of the brush border with an improvement of lactase enzyme activity."
"Lactose breath test should be performed after 12 months in celiac disease patients on a gluten-free diet in order to assess the persistence/disappearance of lactose malabsorption, thus avoiding an unnecessary lactose-free diet."