Year 2015 / Volume 107 / Number 9
Original
THE MANAGEMENT OF LACTOSE INTOLERANCE AMONG PRIMARY CARE PHYSICIANS AND ITS CORRELATION WITH MANAGEMENT BY GASTROENTEROLOGISTS: THE SEPD-SEMG NATIONAL SURVEY

553-558

DOI: 10.17235/reed.2015.3771/2015

Federico Argüelles Arias, Pilar Rodríguez Ledo, Jose Maria Tenias, Mercedes Otero, Francesc Casellas Jordá, Guadalupe Blay Cortés, Alfredo José Lucendo Villarín, José Luis Domínguez Jiménez, Fernando Carballo Alvarez,

Abstract
INTRODUCTION The understanding of lactose intolerance (LI) is limited in some professional settings. Sociedad Española de Patología Digestiva (SEPD) and Sociedad Española de Medicina General (SEMG) have developed a survey in order to: a) Analyze primary care physicians (PCPs) knowledge and clinical management; b) Compare results with those of a previous survey of Spanish gastroenterologists (GEs). MATERIAL AND METHODS An online questionnaire was sent to SEMG members with 27 items on various issues: Demographics, occupational characteristics, outlook on LI, diagnostic tests, treatment, and follow-up. Results were compared to those from a survey of GEs. RESULTS A total of 456 PCPs responded, versus 477 GEs. PCPs had an older mean age and longer professional experience. Level of understanding of LI was similar, albeit a higher proportion of PCPs lacked epidemiological awareness (p<0.01). GEs tended to consider LI a “minor” condition (71.3 vs 40.1%; p>0.001), and LI symptoms as overlapping those of irritable bowel syndrome (93.5 vs 88.2%; p=0.005), although symptoms perceived as suspicious of LI were similar in both groups. Dietary recommendations were recognized as the primary therapeutic approach. CONCLUSION This study reveals the outlook of PCPs on LI, and allows comparison with that of GEs, as a basis for the development of strategies aimed at improving LI understanding, approach and management in our setting.
Share Button
New comment
Comments
No comments for this article
References
1) Kretchmer N. Lactose and lactase – a historical perspective.Gastroenterology 1971; 61: 805–13.
2) Latorre G, Besa P, Parodi CG, et al. Prevalence of lactose intolerance in Chile: a double-blind placebo study. Digestion.2014; 90: 18-26.
3) Guix García J, Rodrigo Gómez JM, Aparisi Quereda L, et al. Lactose intolerance in the Spanish population. Rev Esp Enferm Dig 1974; 42: 367-82.
4) Leis R, Tojo R, Pavón P, et al. Prevalence of lactose malabsorption in Galicia.J Pediatr Gastroenterol Nutr.1997; 25: 296-300.
5) Varela-Moreiras G, Antoine JM, Ruiz-Roso B, et al. Effects of yogurt and fermented-then-pasteurized milk on lactose absorption in an institutionalized elderly group. J Am Coll Nutr. 1992; 11: 168-71.
6) Casellas F, Aparici A, Casaus M, et al. Self-perceived lactose intolerance and lactose breath test in elderly. Eur Geriatr Med 2013; 4: 372-5
7) Jellema P, Schellevis FG, van der Windt DA, et al. Lactose malabsorption and intolerance: a systematic review on the diagnostic value of gastrointestinal symptoms and self-reported milk intolerance. QJM. 2010; 103: 555-72.
8) Gasbarrini A, Corazza GR, Gasbarrini G, et al; 1st Rome H2-Breath Testing Consensus Conference Working Group. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther. 2009; 29 Suppl 1:1-49.
9) Suchy FJ, Brannon PM, Carpenter TO, et al. NIH consensus development conference statement: Lactose intolerance and health. NIH Consens State Sci Statements. 2010; 27: 1-27.
10) Argüelles-Arias F, Tenías JM, Casellas-Jordá F, et al. Results of a nation-wide survey on hypolactasia - How is this condition diagnosed and managed in our setting? Rev Esp Enferm Dig. 2015; 107: 55-6.
11) Gelincik A, Buyukozturk S, Gul H, et al. Confirmed prevalence of food allergy and non-allergic food hypersensitivity in a Mediterranean population. Clin Exp Allergy 2008; 38: 1333–41.
12) Casellas F, Aparici A, Casaus M, et al. Subjective perception of lactose intolerance does not always indicate lactose malabsorption. Clin Gastroenterol Hepatol 2010;8:581-6
13) Dainese R, Casellas F, Mariné-Barjoan E, et al. Perception of lactose intolerance in irritable bowel syndrome patients. Eur J Gastroenterol Hepatol. 2014; 26: 1167-75
14) Shaw AD, Davies GJ. Lactose intolerance: problems in diagnosis and treatment. J Clin Gastroenterol. 1999; 28: 208-16.
15) Fernández-Bañares F. Reliability of symptom analysis during carbohydrate hydrogen-breath tests. Curr Opin Clin Nutr Metab Care. 2012; 15: 494-8
16) Yang J, Fox M, Cong Y, et al. Lactose intolerance in irritable bowel syndrome patients with diarrhoea: the roles ofanxiety, activation of the innate mucosal immune system and visceral sensitivity. Aliment Pharmacol Ther. 2014; 39: 302-11.
17) Vernia P, Di Camillo M, Marinaro V. Lactose malabsorption, irritable bowel syndrome and self-reported milk intolerance. Dig Liver Dis. 2001; 33: 234-9
18) Montalto M, Gallo A, Santoro L, et al. Low-dose lactose in drugs neitherincreases breath hydrogen excretion nor causes gastrointestinal symptoms. Aliment Pharmacol Ther. 2008; 28: 1003-12.
19) Eadala P, Waud JP, Matthews SB, et al. Quantifying the 'hidden' lactose in drugs used for the treatment ofgastrointestinal conditions.Aliment Pharmacol Ther. 2009; 29: 677-87.
20) Tereszkowski CM, Simpson JA, Whiting SJ, et al. Body mass, vitamin D and alcohol intake, lactose intolerance, and television watching influence bonemineral density of young, healthy Canadian women. J Am Coll Nutr. 2012; 31: 24-31.
21) Lehtimäki T, Hemminki J, Rontu R, et al. The effects of adult-type hypolactasia on body height growth and dietary calcium intake from childhood into young adulthood: a 21-year follow-up study--the Cardiovascular Risk in Young Finns Study. Pediatrics. 2006; 118: 1553-9.
Related articles
Citation tools
Argüelles Arias F, Rodríguez Ledo P, Tenias J, Otero M, Casellas Jordá F, Blay Cortés G, et all. THE MANAGEMENT OF LACTOSE INTOLERANCE AMONG PRIMARY CARE PHYSICIANS AND ITS CORRELATION WITH MANAGEMENT BY GASTROENTEROLOGISTS: THE SEPD-SEMG NATIONAL SURVEY. 3771/2015


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1030 visits.
This article has been downloaded 206 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 15/03/2015

Accepted: 30/05/2015

Online First: 20/07/2015

Published: 29/08/2015

Article revision time: 74 days

Article Online First time: 127 days

Article editing time: 167 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology