Volume 38, Issue 11

Beneficial effects of oral tilactase on patients with hypolactasia

P. Portincasa

University Medical School, Bari, Italy, and

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A. Di Ciaula

University Medical School, Bari, Italy, and

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M. Vacca

University Medical School, Bari, Italy, and

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R. Montelli

University Medical School, Bari, Italy, and

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D. Q.‐H. Wang

Harvard Medical School and

Harvard Digestive Diseases Center, Boston, MA, USA

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G. Palasciano

University Medical School, Bari, Italy, and

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First published: 21 October 2008
Citations: 17
Piero Portincasa, MD, PhD, Clinica Medica ‘A. Murri’, Department of Internal Medicine and Public Medicine, University of Bari Medical School, Policlinico, 70124 Bari, Italy. Tel.: +39 80 5478 227; fax: +39 80 5478 232; e‐mail: p.portincasa@semeiotica.uniba.it

ABSTRACT

Background A lactose‐free diet is commonly prescribed to subjects with hypolactasia. We tested the effectiveness of a single ingestion of tilactase (a β‐d‐galactosidase from Aspergillus oryzae) in adults with hypolactasia, previously assessed by lactose H2‐breath test.

Materials and methods After measurement of orocecal transit time (OCTT, by lactulose H2‐breath test) and lactose H2‐breath testing plus placebo, a total of 134 subjects were positive to hypolactasia and underwent lactose H2‐breath testing plus either low (6750 U) or standard (11 250 U) doses of tilactase. The appearance of gastrointestinal symptoms during the tests was monitored.

Results OCTT was longer in malabsorbers (subjects without bloating, abdominal pain and/or diarrhoea, n = 25) than in intolerants (bloating, abdominal pain and/or diarrhoea, n = 109, P < 0·02). Malabsorbers had longer time to H2 peak (P < 0·03), lower H2 peak levels (P < 0·002) and smaller integrated H2 excretion levels (P < 0·005) than intolerants. After tilactase ingestion, integrated H2 levels were decreased by 75% (low dose) and 87% (standard dose) in malabsorbers, and by 74% (low dose) and 88% (standard dose) in intolerants. In the latter group, total symptom score were decreased by 76% (low dose) and by 88% (standard dose) (P < 0·0001).

Conclusion A single oral administration of tilactase is highly effective in decreasing symptoms and hydrogen excretion of hypolactasia assessed by lactose H2‐breath test. If confirmed by long‐term observations, ingestion of tilactase might be a better option than exclusion diets in intolerant subjects with hypolactasia.

Number of times cited according to CrossRef: 17

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