Lactose intolerance laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Since lactose intolerance is the normal state for most adults on a worldwide scale, and not considered a disease condition, diagnosis is not necessarily required.

Confirmation

However, when confirmation is necessary, different tests are suggested:

• Hydrogen Breath Test:

After an overnight fast, 50 grams of lactose (in a solution with water) are swallowed. If the lactose cannot be digested, enteric bacteria metabolize it and produce hydrogen. This can be detected in the air the patient exhales. The test takes about 2 to 3 hours. A medical condition with similar symptoms is fructose malabsorption.

In conjunction, measuring the blood glucose level every 10 - 15 minutes after ingestion will show a "flat curve" in individuals with lactose malabsorption, while the lactase persistent will have a significant "top", with an elevation of typically 50 to 100% within 1 - 2 hours.

• Stool acidity:

Required for a clinical diagnosis.

• Intestinal biopsy:

An intestinal biopsy can confirm lactose intolerance following discovery of elevated hydrogen in the hydrogen breath test.

• Informal test:

Done on someone by having the person follow these steps:

1. Drink 2-4 cups of milk on an empty stomach.
2. For 48 hours abstain from consuming alcohol or any food or medication (may reduce bacterial activity and falsify results) containing dairy in the forms of lactose, whey, or milk solids.
3. Monitor for signs of intestinal discomfort, nausea, vomiting or severe headache / migraine.
4. In presence of these symptoms, lactose intolerance is to be suspected and one should seek medical advice.