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Article

Whole Cow’s Milk but Not Lactose Can Induce Symptoms inPatients with Self-Reported Milk Intolerance: Evidence of Cow’s Milk Sensitivity in Adults

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Unit of Internal Medicine, “V. Cervello” Hospital, Ospedali Riuniti “Villa Sofia-Cervello”, 90146 Palermo, Italy
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Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
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Unit of Internal Medicine, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
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Unit of Pathology, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Elvira Verduci
Nutrients 2021, 13(11), 3833; https://doi.org/10.3390/nu13113833
Received: 2 October 2021 / Revised: 19 October 2021 / Accepted: 25 October 2021 / Published: 27 October 2021
(This article belongs to the Special Issue Cow's Milk and Human Health)
Background: Lactose intolerance is the most frequent food intolerance, but many subjects with self-reported milk intolerance (SRMI) are asymptomatic at lactose hydrogen breath test (LHBT). The aim of this study was to evaluate the frequency of lactose intolerance in SRMI patients and their clinical characteristics. Methods: In a retrospective study, the clinical records of 314 SRMI patients (259 females, mean age: 39.1 ± 13.5 years) were reviewed; 102 patients with irritable bowel syndrome (IBS) served as controls. In a prospective study, 42 SRMI patients, negatives at the LHBT, underwent a double-blind, placebo-controlled (DBPC) whole cow’s milk challenge. Results: In the retrospective study, only 178 patients (56%) were lactose maldigesters and intolerant at LHBT; 68% of the subjects with SRMI were suffering from IBS; 74% reported dyspepsia (p = 0.0001 vs. IBS controls); and weight loss was recorded in 62 SRMI patients (20%) (p = 0.01 vs. IBS controls). Duodenal histology showed intra-epithelial lymphocytosis in about 60% of cases. In the prospective study, 36 patients (86%) experienced symptoms during the DBPC cow’s milk challenge, and only 4 patients (9%) reacted to placebo (p = 0.0001). Conclusions: A percentage of SRMI patients were not suffering from lactose intolerance. DBPC revealed that SRMI patients had clinical reactions when exposed to whole cow’s milk. View Full-Text
Keywords: self-reported milk intolerance; lactose intolerance; lactose hydrogen breath test; cow’s milk protein allergy; IBS; HLA; duodenal histology self-reported milk intolerance; lactose intolerance; lactose hydrogen breath test; cow’s milk protein allergy; IBS; HLA; duodenal histology
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MDPI and ACS Style

Carroccio, A.; Soresi, M.; Mantia, B.; Fayer, F.; La Blasca, F.; Seidita, A.; D’Alcamo, A.; Florena, A.M.; Tinè, C.; Garlisi, C.; Mansueto, P. Whole Cow’s Milk but Not Lactose Can Induce Symptoms inPatients with Self-Reported Milk Intolerance: Evidence of Cow’s Milk Sensitivity in Adults. Nutrients 2021, 13, 3833. https://doi.org/10.3390/nu13113833

AMA Style

Carroccio A, Soresi M, Mantia B, Fayer F, La Blasca F, Seidita A, D’Alcamo A, Florena AM, Tinè C, Garlisi C, Mansueto P. Whole Cow’s Milk but Not Lactose Can Induce Symptoms inPatients with Self-Reported Milk Intolerance: Evidence of Cow’s Milk Sensitivity in Adults. Nutrients. 2021; 13(11):3833. https://doi.org/10.3390/nu13113833

Chicago/Turabian Style

Carroccio, Antonio, Maurizio Soresi, Beatrice Mantia, Francesca Fayer, Francesco La Blasca, Aurelio Seidita, Alberto D’Alcamo, Ada M. Florena, Chiara Tinè, Chiara Garlisi, and Pasquale Mansueto. 2021. "Whole Cow’s Milk but Not Lactose Can Induce Symptoms inPatients with Self-Reported Milk Intolerance: Evidence of Cow’s Milk Sensitivity in Adults" Nutrients 13, no. 11: 3833. https://doi.org/10.3390/nu13113833

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