Do patients with lactose intolerance exhibit more frequent comorbidities than patients without lactose intolerance? An analysis of routine data from German medical practices

Background The increase in food intolerances poses a burgeoning problem in our society. Food intolerances not only lead to physical impairment of the individual patient but also result in a high socio-economic burden due to factors such as the treatment required as well as absenteeism. The present study aimed to explore whether lactose intolerant (LI) patients exhibit more frequent comorbidities than non-LI patients. Methods The study was conducted on a case-control basis and the results were determined using routine data analysis. Routine data from the IMS Disease Analyzer database were used for this purpose. A total of 6,758 data records were processed and analyzed. Results There were significant correlations between LI and the incidence of osteoporosis, changes in mental status, and the presence of additional food intolerances. Comparing 3,379 LI vs. 3,379 non-LI patients, 34.5% vs. 17.7% (P<0.0001) suffered from abdominal pain; 30.6% vs. 17.2% (P<0.0001) from gastrointestinal infections; and 20.9% vs. 16.0% (P=0.0053) from depression. Adjusted odds ratios (OR) were the highest for fructose intolerance (n=229 LI vs. n=7 non-LI; OR 31.06; P<0.0001), irritable bowel syndrome (n=247 LI vs. n=44 non-LI; OR 5.23; P<0.0001), and bloating (n=351 LI vs. n=68 non-LI; OR 4.94; P<0.0001). Conclusion The study confirms that LI should not be regarded as an isolated illness but considered a possible trigger for further diseases. Additional research is necessary to assert more precise statements.

[1]  R. Spiller,et al.  Irritable bowel syndrome , 2015, Nature Reviews Disease Primers.

[2]  T. Kapellen,et al.  Verwendung von Off-Label-Medikamenten bei ambulant betreuten Kindern und Jugendlichen in Deutschland , 2013, Deutsche Medizinische Wochenschrift.

[3]  W. Rathmann,et al.  Changes in time to insulin initiation in type 2 diabetes patients: a retrospective database analysis in Germany and UK (2005-2010). , 2013, Primary care diabetes.

[4]  M. Intorcia,et al.  GRAND: the German retrospective cohort analysis on compliance and persistence and the associated risk of fractures in osteoporotic women treated with oral bisphosphonates , 2011, Osteoporosis International.

[5]  T. Wilt,et al.  Systematic Review: Effective Management Strategies for Lactose Intolerance , 2010, Annals of Internal Medicine.

[6]  K. Kostev,et al.  Relation of the first hypertension-associated event with medication, compliance and persistence in naïve hypertensive patients after initiating monotherapy. , 2010, International journal of clinical pharmacology and therapeutics.

[7]  J. Sanderson,et al.  Review article: lactose intolerance in clinical practice – myths and realities , 2007, Alimentary pharmacology & therapeutics.

[8]  F. Lammert,et al.  Laktoseintoleranz: Neue Aspekte eines alten Problems , 2007 .

[9]  M. Heyman Lactose Intolerance in Infants, Children, and Adolescents , 2006, Pediatrics.

[10]  J. Lubiński,et al.  Lactase persistence and ovarian carcinoma risk in Finland, Poland and Sweden , 2005, International journal of cancer.

[11]  A. Gasbarrini,et al.  Abnormal breath tests to lactose, fructose and sorbitol in irritable bowel syndrome may be explained by small intestinal bacterial overgrowth , 2005, Alimentary pharmacology & therapeutics.

[12]  N. Barnard,et al.  Calcium, Dairy Products, and Bone Health in Children and Young Adults: A Reevaluation of the Evidence , 2005, Pediatrics.

[13]  B. Obermayer-Pietsch Knochendichte und Laktoseintoleranz - Übersicht über aktuelle Entwicklungen , 2004 .

[14]  P. Vandvik,et al.  Lactose malabsorption in a population with irritable bowel syndrome: prevalence and symptoms. A case‐control study , 2004, Scandinavian journal of gastroenterology.

[15]  A. Berghold,et al.  Genetic Predisposition for Adult Lactose Intolerance and Relation to Diet, Bone Density, and Bone Fractures , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[16]  M. Yalovsky,et al.  Fructose and Sorbitol Malabsorption in Ambulatory Patients with Functional Dyspepsia Comparison with Lactose Maldigestion/Malabsorption , 1997, Digestive Diseases and Sciences.

[17]  Sheila M. Williams,et al.  Children who avoid drinking cow milk have low dietary calcium intakes and poor bone health. , 2002, The American journal of clinical nutrition.

[18]  G. Corazza,et al.  Lactose malabsorption and intolerance and peak bone mass. , 2002, Gastroenterology.

[19]  C. Böhmer,et al.  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 , 2001, European journal of gastroenterology & hepatology.

[20]  D. Fuchs,et al.  Fructose- and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers. , 2000, Scandinavian journal of gastroenterology.

[21]  D. Fuchs,et al.  Fructose malabsorption is associated with decreased plasma tryptophan. , 1999, Advances in experimental medicine and biology.

[22]  J. Lamont of Gastroenterology , 2022 .

[23]  C. Weaver,et al.  Dietary calcium: adequacy of a vegetarian diet. , 1994, The American journal of clinical nutrition.

[24]  A. Tamm,et al.  Metabolism of lactose in the human body. , 1994, Scandinavian journal of gastroenterology. Supplement.

[25]  T. Sahi,et al.  Genetics and epidemiology of adult-type hypolactasia. , 1994, Scandinavian journal of gastroenterology. Supplement.

[26]  P. Ferenci,et al.  [Effect of a lactose-free diet on irritable bowel syndrome]. , 1993, Wiener klinische Wochenschrift.

[27]  H. Büller,et al.  Lactose intolerance , 1991, The Lancet.

[28]  P. Bartholdi,et al.  Calcium absorption from milk in lactase-deficient subjects. , 1989, The American journal of clinical nutrition.

[29]  G. Sturniolo,et al.  [Irritable bowel syndrome]. , 1988, Giornale di clinica medica.

[30]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.

[31]  D. McGill,et al.  Irritable bowel syndrome. Role of lactase deficiency. , 1983, Mayo Clinic proceedings.

[32]  L. B. Winter The metabolism of lactose , 1932, The Journal of physiology.