Lactose intolerance in allergic enterocolitis in infants

O.G. Shadrin, H.A. Haiduchyk


Background. Food allergy in the infancy is manifested clinically in damage to the skin and gastrointestinal tract. Allergic inflammation of the intestinal mucosa is accompanied by damage to the structure of enterocytes, which can lead to a significant reduction in the lactase enzyme on their apical surface. Materials and methods. Sixty-two children aged 2 months to 1 year with allergic enterocolitis were examined. To diagnose lactase deficiency, a hydrogen breath test with food lactose load was performed using portable monitor for determining hydrogen (H2) concentration in the exhaled air — Gastro+ Gastrolyzer manufactured by Bedfont Scientific Ltd. (UK). Results. Comprehensive assessment of the results of a hydrogen breath test with food lactose load revealed the presence of lactase deficiency and lactose-dependent small intestinal bacterial overgrowth in children with allergic enterocolitis: in protein-induced enterocolitis syndrome — in 70.3 and 14.8 % of cases, respectively, in protein-induced enteropathy — in 100.0 and 41.6 %, in protein-induced proctocolitis — in 36.0 and 32.0 % of infants, respectively. Conclusions. According to the results of a hydrogen breath test with food lactose load, 40 (62.5 %) infants with allergic enterocolitis have been diagnosed with lactose intolerance and 17 (26.6 %) — with lactose-dependent small intestinal bacterial overgrowth that are secondary and need correction in the acute period of treatment for the underlying disease.


children; lactose intolerance; allergic enterocolitis; hydrogen breath test; bacterial overgrowth syndrome


Shadrin OG, Gayduchik GA, Kovalchuk AA, Dyukareva SV, Bondarenko NYu. Optimization of treatment of gastrointestinal food allergy in infants. Perinatologiya i pediatriya. 2015;(63): 84-88. (in Ukrainian).

Roehr CC, Edenharter G, Reimann S, et al. Food allergy and non-allergic food hypersensitivity in children and adolescents. Clin Exp Allergy. 2004 Oct;34(10):1534-41. doi:10.1111/j.1365-2222.2004.02080.

Nowak-Węgrzyn A. Food protein-induced enterocolitis syndrome and allergic proctocolitis. Allergy Asthma Proc. 2015 May-Jun;36(3):172-84. doi: 10.2500/aap.2015.36.3811.

Anania C, Pacifico L, Olivero G, Osborn JF, Bonaiuto E, Chiesa C. Breath tests in pediatrics. Clin Chim Acta. 2008 Nov;397(1-2):1-12. doi: 10.1016/j.cca.2008.07.023.

Gijsbers CF, Kneepkens CM, Büller HA. Lactose and fructose malabsorption in children with recurrent abdominal pain: results of double-blinded testing. Acta Paediatr. 2012 Sep;101(9):e411-5. doi: 10.1111/j.1651-2227.2012.02721.x.

Mukhina IuG, Shumilov PV, Chubarova AI. Malabsorption syndrome. In: Baranov AA, Blokhin BM, Bogomil'skii MR, et al., authors; Baranov AA, editor. Pediatriia: natsional'noe rukovodstvo. Tom 1 [Pediatrics: a national guide. Vol 1]. Moscow: GEOTAR-Media; 2009. 749-771 pp. (in Russian).

Ploskireva AA, Gorelov AV. Step-up dietotherapy of secondary lactase insufficiency in acute intestinal infections in childrens. RMJ. 2012;20(24):1189-1192. (in Russian).

Mitra SK, Sachan A, Udupa V, Seshadri SJ, Jayakumar K. Histological changes in intestine in semichronic diarrhea induced lactose enriched diet in rats: effect of Diarex-Vet. Indian J Exp Biol. 2003 Mar;41(3):211-5.

Raithel M, Weidenhiller M, Hagel AF, Hetterich U, Neurath MF, Konturek PC. The malabsorption of commonly occurring mono and disaccharides: levels of investigation and differential diagnoses. Dtsch Arztebl Int. 2013 Nov 15;110(46):775-82. doi: 10.3238/arztebl.2013.0775.

Okhotnikova OM, Hladush YuI, Bondarenko LV, et al. Gastrointestinal food allergy in children - pressing issue at present. Zdorovʹe rebenka. 2015;(60):29-35. doi: 10.22141/2224-0551.1.60.2015.74936. (in Ukrainian).

Hayduchyk GA. Optimization of the treatment of allergic enterocolitis in young children. Sovremennaya pediatriya. 2018;(93):49-53. (in Ukrainian).

Levitt M, Wilt Т, Shaukat А. Clinical implications of lactose malabsorption versus lactose intolerance. J Clin Gastroenterol. 2013 Jul;47(6):471-80. doi: 10.1097/MCG.0b013e3182889f0f.

Nowak-Wegrzyn A, Chehade М, Groetch МЕ, et al. International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: executive summary-workgroup report of the adverse reactions to foods committee, American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol. 2017 Apr;139(4):1111-1126.e4. doi: 10.1016/j.jaci.2016.12.966.

Rana SV, Malik A. Hydrogen breath tests in gastrointestinal diseases. Indian J Clin Biochem. 2014 Oct;29(4):398-405. doi: 10.1007/s12291-014-0426-4.

Dabritz J, Muhlbauer M, Domagk D, et al. Significance of hydrogen breath tests in children with suspected carbohydrate malabsorption. BMC Pediatr. 2014 Feb 27;14:59. doi: 10.1186/1471-2431-14-59.

Gasbarrini A, Corazza GR, Gasbarrini G, et al. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther. 2009 Mar 30;29 Suppl 1:1-49. doi: 10.1111/j.1365-2036.2009.03951.x.

Bate JP, Irving PM, Barrett JS, Gibson PR. Benefits of breath hydrogen testing after lactulose administration in analysing carbohydrate malabsorption. Eur J Gastroenterol Hepatol. 2010 Mar;22(3):318-26. doi: 10.1097/MEG.0b013e32832b20e8.

Misselwitz B, Pohl D, Frühauf H, Fried M, Vavricka SR, Fox M. Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. United European Gastroenterol J. 2013 Jun;1(3):151-9. doi: 10.1177/2050640613484463.

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