P205. Lactose intolerance in inflammatory bowel disease patients
C. Menezes1, R. Rocha1, F. Coqueiro1, M. Lopes1, P. Nunes1, L. Sales1, C. Factum1, N. Almeida2, G. Santana2, B. César da Silva2, 1Universidade Federal da Bahia, Nutrição, Salvador, Brazil, 2Universidade Federal da Bahia, Gastroenterologia, Salvador, Brazil
Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) considered independent risk factors for the development of lactose maldigestion. Patients with these clinical conditions usually make restriction of dairy products believing they harm their clinical or because of health professionals indication. However, the assertion that this group of patients has lactose intolerance (LI) remains controversial. The aim of this study was to identify the frequency of LI in a group of IBD patients.
IBD patients in outpatient treatment were appraised from August to November 2012. Hydrogen breath test (HBT) was used to diagnose lactose maldigestion. To this, the first sample of exhaled air was collected in fasting, followed by another sample, 1 hour after ingestion of 25g of lactose solution at 10%, and by other four consecutive samples every 30 minutes, totaling three hours of analysis. The HBT was considered positive if at least one sample increased more than 20ppm of hydrogen compared to baseline. LI was diagnosed by positive HBT associated with the presence of gastrointestinal disorders.
Eighty-three adult IBD patients were appraised, 49 UC patients and 34 CD patients. Most were female (61.4%) and were between 31 and 50 years old (62.7%). The frequency of LI was 31.3% in IBD patients. In UC patients, the frequency of LI was 28.6%, and among those CD patients, 35.3% were considered intolerant (p = 0.51). Of all LI patients, 80.8% were women (p = 0.01), 57.7% were between 31 and 50 years old and 46.2% were diagnosed less than 5 years before, however the last two data showed no statistically significant differences when comparing the groups with and without LI diagnosis (p = 0.76; p = 0.46; respectively). Of the 38 patients who had some restriction of dairy products, 60.5% were diagnosed negative for LI.
LI was common in both UC and CD patients, however the most part of patients who restrict dairy products did not present LI. These findings emphasize the importance of investigating LI in IBD patients and of the individualization of dietary behaviors, so that unnecessary restrictions can be avoided.