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Systematic review
Sufficient evidence that 12 g of lactose is tolerated by most adults with lactose malabsorption and intolerance but insufficient evidence on the effectiveness of therapeutical strategies tested so far
  1. Massimo Montalto1,
  2. Antonella Gallo1
  1. Institute of Internal Medicine, Catholic University, Rome, Italy
  1. Correspondence to Massimo Montalto
    Institute of Internal Medicine, Catholic University, Largo A. Gemelli, 8, 00168, Rome, Italy; mmontalto{at}

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Lactose malabsorption is a very common condition caused by a deficiency of the intestinal enzyme that hydrolyses lactose into its components, galactose and glucose. High concentrations of lactase are physiologically present in neonates whereas, after weaning, a genetically programmed and irreversible reduction in its activity occurs in a majority of the world's population. Therefore, hypolactasia should not be considered a disease but rather a common pattern in human physiology. The presence in the colonic lumen of malabsorbed lactose does not necessarily result in gastrointestinal symptoms. When this condition is related to uncomfortable clinical manifestations as bloating, abdominal pain and diarrhoea, ‘lactose intolerance’ occurs. At present, the management of this condition is still an open matter.


Shaukat and colleagues' systematic review examines two important aspects of this topic: the assessment of the maximum tolerable dose of lactose and the interventions to reduce symptoms in patients with lactose intolerance. The authors independently selected and reviewed the relevant studies obtained from …

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  • Competing interests None.