Is a Lactose-Restricted Diet Reasonable for Patients with Abdominal Complaints not Organically Explained?
DOI: 10.3238/zfa.2016.0390-0396german translation / full article
Introduction: Chronic abdominal complains (CAC) are a frequent problem in family practice. Not uncommonly, undiagnosed lactose intolerance (LIT) is the reason and symptoms should improve under a lactose-restricted diet (LRD). The present study aimed to clarify, to what extent patients with and without LIT respond to a LRD and whether the result of a specific therapy in LIT could prove its causality.
Methods: In family practices all patients with CAC and no definite diagnosis underwent LIT gene testing (LI+/LI–). All retrieved persons were informed about their status and all were advised to keep to a LRD, verbally and with a brochure. Well-being, adherence to the diet and specific symptoms (the last by the standardized questionnaire GIQLI) were documented at three times by telephone interviews.
Results: 25 practices with 210 patients (64 LI+) participated. All patients improved significantly in the GIQLI scores without a significant difference between LI+ and LI– . 74 % of LI+ and 50 % of LI– patients stated a subjective benefit. 61 % of LI+ und 39 % of LI– planned to continue the diet after the end of the study.
Conclusions: LRD seems to have a specific as well as an unspecific (placebo) effect. Similar findings have been shown in several studies. It is worthwhile to offer a LRD to all patients with CAC of unknown origin; in particularly as for the majority no good therapeutic options are available.