Self-perceived lactose intolerance and lactose breath test in elderly

BackgroundLactose maldigestion is quite common at all ages. Lactose maldigestion is also common in the elderly but information relative to their symptoms is scarce.Purpose To determine whether in the elderly self-reported lactose intolerance in the normal home setting is comparable to symptoms provoked by a controlled lactose challenge.Design Observational, prospective and transverse study performed in patients referred for a lactose H2 breath test.Material and methodsPatients first completed a validated questionnaire inquiring about symptoms associated with usual consumption of dairy products at home (“home symptoms”). After a 50-g lactose breath test, symptoms score was also obtained. Patients were grouped as absorbers versus malabsorbers (according to the lactose test result) and younger or older than 65 years old.ResultsSix hundred and one patients have been included (89 older than 65 years old and 512 younger than 65 years). Prevalence of lactose maldigestion was the same in both age groups (50% vs 51%). In lactose maldigesters, orocecal transit time and hydrogen excretion capacity after lactose load were independent of age. Oral lactose load induces symptoms in lactose maldigesters. Lactose-induced intolerance symptoms were less intense in elderly than in younger adults (symptoms score of 8 vs 19, P < 0.001). Home symptoms were not related to lactose digestion capacity.ConclusionsIn the elderly, lactose maldigestion is associated with increased excretion of hydrogen after oral 50 g lactose load but symptoms are less marked than in younger adults. Self-reported intolerance symptoms at home are not clearly related to lactose maldigestion in elderly.