Incidence and clinical significance of lactose malabsorption in adult coeliac disease

Scand J Gastroenterol. 1988 May;23(4):484-8. doi: 10.3109/00365528809093898.

Abstract

Fifty-one adult patients with coeliac disease, verified by a proximal small-intestinal biopsy, were investigated. Before treatment with a gluten-free and low-lactose diet 52% showed a slight rise in blood glucose during the lactose tolerance test. Seventy-nine per cent of these patients had watery stools, and 88% had three or more bowel movements a day--statistically significantly different from the coeliac patients with a normal lactose tolerance test. After treatment 12% had a flat lactose tolerance curve. Half of them (6%) had specific lactase deficiency. This is approximately the incidence of lactose malabsorption in the general Danish population. The small-intestinal disaccharidases and alkaline phosphatase levels were severely depressed before treatment. After treatment the activities increased, but not to normal. We conclude that lactose malabsorption is a clinically important condition in many patients with untreated coeliac disease, giving rise to more frequent and more watery stools. In well-treated coeliac disease lactose malabsorption is not commoner than in the general population. The lactose activity in a proximal intestinal biopsy specimen was found to be an unreliable indicator of lactose malabsorption in coeliac disease.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / analysis
  • Celiac Disease / complications*
  • Celiac Disease / metabolism
  • Female
  • Humans
  • Intestine, Small / enzymology
  • Lactose Intolerance / etiology*
  • Lactose Intolerance / metabolism
  • Lactose Tolerance Test
  • Male
  • Middle Aged
  • beta-Galactosidase / metabolism

Substances

  • Blood Glucose
  • beta-Galactosidase