Evaluation of lactose and milk intolerance, and bone mineral density in Indian patients with inflammatory bowel disease.
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Date
2012-11
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Abstract
Background. A misconception that milk and lactose
intolerance increases disease activity in inflammatory bowel
disease leads to the exclusion of dietary dairy products, and
patients are at an increased risk of low bone mineral density.
Methods. Patients with inflammatory bowel disease (n=45,
19 men and 26 women) and healthy controls were included
in this prospective open-label study. As part of exploratory
dietary intervention, patients were advised to exclude milk and
milk products from diet for the first 7 days and reintroduce at
least 250 ml of milk for the next 21 days. Milk and lactose
intolerance was assessed in patients and healthy subjects using
clinical symptoms and lactose hydrogen breath test, respectively;
bone mineral density was assessed in patients using a Hologic
QDR 4500A DXA machine.
Results. Milk and lactose intolerance was statistically
comparable in patients with inflammatory bowel disease (31%
and 44%, respectively) and healthy subjects (22% and 27%,
respectively). Most of the patients (40%) had excluded dairy
products from their diet, and 53% had dietary intake of
calcium <200 mg/day. More than 60% of the patients had
either osteopenia or osteoporosis.
Conclusion. Milk and lactose intolerance in patients with
inflammatory bowel disease was not different from that in
healthy subjects. The proportion of patients with osteoporosis
and osteopenia was high in this population. Hence, patients
with inflammatory bowel disease in remission phase may be
encouraged to add dairy products in their diet, unless otherwise
indicated.
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GUPTA RICHA, MAKHARIA GOVIND, KHADGAWAT RAJESH, KUMAR YADAV RAJ. Evaluation of lactose and milk intolerance, and bone mineral density in Indian patients with inflammatory bowel disease. National Medical Journal of India. 2012 Nov-Dec ; 25(6): 327-331.