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Nutrients 2015, 7(9), 7505-7522; doi:10.3390/nu7095349

Contribution of Colonic Fermentation and Fecal Water Toxicity to the Pathophysiology of Lactose-Intolerance

1
Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven 3000, Belgium
2
Laboratory Medicine, University Hospitals Leuven, Leuven 3000, Belgium
3
Leuven Food Science and Nutrition Research Centre (LFoRCe), KU Leuven, Leuven 3000, Belgium
*
Author to whom correspondence should be addressed.
Received: 15 July 2015 / Revised: 13 August 2015 / Accepted: 21 August 2015 / Published: 8 September 2015
(This article belongs to the Special Issue Lactose Intolerance: Biology, Genetics and Dietary Management)
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Abstract

Whether or not abdominal symptoms occur in subjects with small intestinal lactose malabsorption might depend on differences in colonic fermentation. To evaluate this hypothesis, we collected fecal samples from subjects with lactose malabsorption with abdominal complaints (LM-IT, n = 11) and without abdominal complaints (LM-T, n = 8) and subjects with normal lactose digestion (NLD, n = 15). Lactose malabsorption was diagnosed using a 13C-lactose breath test. Colonic fermentation was characterized in fecal samples at baseline and after incubation with lactose for 3 h, 6 h and 24 h through a metabolomics approach using gas chromatography-mass spectrometry (GC-MS). Fecal water cytotoxicity was analyzed using a colorimetric assay. Fecal water cytotoxicity was not different between the three groups (Kruskall-Wallis p = 0.164). Cluster analysis of the metabolite patterns revealed separate clusters for NLD, LM-T and LM-IT samples at baseline and after 24 h incubation with lactose. Levels of 5-methyl-2-furancarboxaldehyde were significantly higher in LM-IT and LM-T compared to NLD whereas those of an unidentified aldehyde were significantly higher in LM-IT compared to LM-T and NLD. Incubation with lactose increased short chain fatty acid (SCFA) concentrations more in LM-IT and LM-T compared to NLD. In conclusion, fermentation patterns were clearly different in NLD, LM-IT and LM-T, but not related to differences in fecal water cytotoxicity. View Full-Text
Keywords: lactose intolerance; lactose malabsorption; colonic fermentation; metabolomics; cytotoxicity lactose intolerance; lactose malabsorption; colonic fermentation; metabolomics; cytotoxicity
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Windey, K.; Houben, E.; Deroover, L.; Verbeke, K. Contribution of Colonic Fermentation and Fecal Water Toxicity to the Pathophysiology of Lactose-Intolerance. Nutrients 2015, 7, 7505-7522.

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