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ORIGINAL ARTICLE
Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 300-306

Assessment of lactose intolerance in adult Egyptian patients with dyspeptic symptoms using lactase enzyme assay in duodenal biopsy


1 Department of Hepatogastro-Enterology and Infectious Diseases, Faculty of Medicine for Girls, Al Zahraa University Hospital, Cairo, Egypt
2 Department of Biochemistry, Faculty of Medicine for Girls, Al Zahraa University Hospital, Cairo, Egypt
3 Department of Hepatogastroenterology and Infectious Disease, Medical Administration for Girls, Al Zahraa University Hospital, Cairo, Egypt

Correspondence Address:
MD Alshimaa M. M Eid
Lecturer of Hepatogastroenterology and Infectious Disease, Al Zahraa University Hospital, Al- Mokattam, Street 9, Building no. 7084 – Second Floor, ZIP/Postal Code: 11571
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjamf.sjamf_53_20

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Objective To assess the role of endoscopic duodenal biopsies in diagnosing lactose intolerance of adult Egyptian patients with dyspeptic symptoms. Patients and methods A validated self-administered questionnaire was applied on 200 patients for symptom assessment after ingestion of lactose or lactose products. They are referred to the Hepatogastro-enterology and Infectious Diseases Department of Al-Zahraa University Hospital during the period from December 2018 to December 2019. Forty adult patients out of 200 were selected and subjected to history taking, clinical, laboratory evaluation, stool analysis, and abdominal ultrasound. They underwent upper gastrointestinal (GI) endoscopy and two postbulbar duodenal biopsies were taken for histopathology and biochemical assay of the lactase enzyme. Results The symptom questionnaire of 200 patients after ingestion of lactose-containing products showed that the mean and SD score of flatulence was the highest score (5.69±0.24); abdominal cramping was 3.29±0.16 while diarrhea was 0.84±0.09 and vomiting was the lowest score (0.30±0.05). Forty patients were selected for upper GI endoscopy with a mean age of 35.15±12.14 years; of the patients, 70.0% were women and 30.0% were men There was no statistically significant results as regards laboratory data or abdominal ultrasound. According to the values of lactase enzyme level in duodenal biopsies; 65% of patients had mild hypolactasia compared with 35% who were constant with normo lactasia and no patients with severe hypolactasia. Conclusion Adult patients with lactose intolerance mainly complain of abdominal cramps and flatulence more than other GI tract symptoms. Biochemical assay of lactase enzyme 35% who were constant with normolactasia and no patients with severe hypolactasia.


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