The Experts below are selected from a list of 237 Experts worldwide ranked by ideXlab platform
Jeremy D Sanderson - One of the best experts on this subject based on the ideXlab platform.
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review article lactose intolerance in clinical practice myths and realities
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Miranda Lomer, Jeremy D Sanderson, Gareth ParkesAbstract:Summary Background Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance. Aims To review current clinical practice and identify published literature on the management of lactose intolerance. Methods PubMed was searched using the terms lactose, Lactase and diet to find original research and reviews. Relevant articles and clinical experience provided the basis for this review. Results Lactose is found only in mammalian milk and is hydrolysed by Lactase in the small intestine. The Lactase gene has recently been identified. ‘Wild-type’ is characterized by Lactase nonpersistence, often leading to lactose intolerance. Two genetic polymorphisms responsible for persistence have been identified, with their distribution concentrated in north Europeans. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms. Conclusion In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction.
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Review article: lactose intolerance in clinical practice – myths and realities
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Miranda Lomer, Gareth Parkes, Jeremy D SandersonAbstract:Summary Background Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance. Aims To review current clinical practice and identify published literature on the management of lactose intolerance. Methods PubMed was searched using the terms lactose, Lactase and diet to find original research and reviews. Relevant articles and clinical experience provided the basis for this review. Results Lactose is found only in mammalian milk and is hydrolysed by Lactase in the small intestine. The Lactase gene has recently been identified. ‘Wild-type’ is characterized by Lactase nonpersistence, often leading to lactose intolerance. Two genetic polymorphisms responsible for persistence have been identified, with their distribution concentrated in north Europeans. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms. Conclusion In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction.
Miranda Lomer - One of the best experts on this subject based on the ideXlab platform.
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review article lactose intolerance in clinical practice myths and realities
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Miranda Lomer, Jeremy D Sanderson, Gareth ParkesAbstract:Summary Background Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance. Aims To review current clinical practice and identify published literature on the management of lactose intolerance. Methods PubMed was searched using the terms lactose, Lactase and diet to find original research and reviews. Relevant articles and clinical experience provided the basis for this review. Results Lactose is found only in mammalian milk and is hydrolysed by Lactase in the small intestine. The Lactase gene has recently been identified. ‘Wild-type’ is characterized by Lactase nonpersistence, often leading to lactose intolerance. Two genetic polymorphisms responsible for persistence have been identified, with their distribution concentrated in north Europeans. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms. Conclusion In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction.
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Review article: lactose intolerance in clinical practice – myths and realities
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Miranda Lomer, Gareth Parkes, Jeremy D SandersonAbstract:Summary Background Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance. Aims To review current clinical practice and identify published literature on the management of lactose intolerance. Methods PubMed was searched using the terms lactose, Lactase and diet to find original research and reviews. Relevant articles and clinical experience provided the basis for this review. Results Lactose is found only in mammalian milk and is hydrolysed by Lactase in the small intestine. The Lactase gene has recently been identified. ‘Wild-type’ is characterized by Lactase nonpersistence, often leading to lactose intolerance. Two genetic polymorphisms responsible for persistence have been identified, with their distribution concentrated in north Europeans. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms. Conclusion In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction.
Richard J Grand - One of the best experts on this subject based on the ideXlab platform.
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Lactose malabsorption
Current Treatment Options in Gastroenterology, 2008Co-Authors: Richard J Grand, Robert K. MontgomeryAbstract:Lactose malabsorption is a syndrome producing constellation of symptoms, including abdominal pain, bloating, flatulence, diarrhea, and sometimes nausea and/or vomiting. Primary causes of lactose malabsorption due to loss of intestinal Lactase activity include genetic/racial Lactase nonpersistence, congenital Lactase deficiency, and developmental Lactase deficiency. Secondary lactose malabsorption can be caused by any disorder that injures the small intestinal mucosa, such as viral gastroenteritis, celiac disease, allergic (eosinophilic) gastroenteritis, and radiation enteritis. The diagnosis depends on careful clinical evaluation and is customarily confirmed with a lactose breath hydrogen test. As the symptoms are nonspecific, many adults diagnosed with lactose malabsorption actually have irritable bowel syndrome. Treatment consists of a trial of eliminating lactose-containing dairy foods, with supplementation of alternative calcium and protein sources. Commercial enzyme products containing β-galactosidases can be prescribed to help patients digest dietary lactose. Long-term lactose restriction usually is not necessary and can lead to reduced bone mineral density.
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Lactose intolerance and Lactase deficiency in children
Current Opinion in Pediatrics, 1994Co-Authors: Edmond H. H. M. Rings, Richard J Grand, Hans A BullerAbstract:The term Lactase deficiency is widely used to indicate a low or absent level of Lactase enzyme in the small intestine, leading to lactose intolerance. This term is correctly used when the intestinal mucosa is damaged and results in secondary Lactase deficiency. In the case of the genetically determined decrease of Lactase activity during childhood, however, low Lactase levels suggest that the majority of the world's population is "abnormal," whereas individuals from caucasian extraction with high levels of Lactase enzyme throughout life are then considered "normal." It would be better to ascribe racial and ethnic lactose malabsorption as the result of genetically determined reduction of Lactase activity, rather then implying an "abnormality" by the term, "deficiency." Recent studies reveal that this genetic control is at the transcriptional level. The symptomatology of lactose intolerance varies widely, and the diagnostic method of choice is the lactose breath hydrogen test in combination with clinical findings, although small intestinal biopsies should be performed when mucosal diseases are suspected. Treatment of lactose intolerance depends on the age of the child. In young infants complete restriction of lactose containing foods is rarely necessary.
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lactose intolerance and the genetic regulation of intestinal Lactase phlorizin hydrolase
The FASEB Journal, 1991Co-Authors: Robert K. Montgomery, Edmond H. H. M. Rings, Hans A Buller, Richard J GrandAbstract:Lactase-phlorizin hydrolase, which hydrolyzes lactose, the major carbohydrate in milk, plays a critical role in the nutrition of the mammalian neonate. Lactose intolerance in adult humans is common, usually due to low levels of small intestinal Lactase. Low Lactase levels result from either intestinal injury or (in the majority of the world's adult population) alterations in the genetic expression of Lactase. Although the mechanism of decreased Lactase levels has been the subject of intensive investigation, no consensus has yet emerged. Recent studies have begun to define the cellular and molecular biology of this enzyme. In animals and humans, a glycosylated precursor is proteolytically cleaved to yield the mature enzyme on the microvillus membrane of the enterocyte, bound to the lipid bilayer only by a hydrophobic anchor sequence. The enzyme hydrolyzes lactose, phlorizin, and glycosylceramides. A decline in Lactase specific activity occurs at the time of weaning in most mammalian species; in most humans...
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Clinical aspects of lactose intolerance in children and adults.
Scandinavian Journal of Gastroenterology, 1991Co-Authors: Hans A Buller, Robert K. Montgomery, Edmond H. H. M. Rings, Richard J GrandAbstract:The principal carbohydrate of human milk is the disaccharide lactose. In human and all mammalian species, lactose is hydrolyzed in the small intestine by Lactase-phlorizin hydrolase, also abbreviated as Lactase. The absence of Lactase results in the passage of undigested lactose into the large intestine and is associated with a well-known clinical syndrome: lactose intolerance. Low Lactase levels result either from intestinal injury or, as in the majority of world's adult population, from alterations in the genetic expression of Lactase. In this review terminology, pathophysiology, symptoms, diagnostic procedures, and therapy of lactose intolerance will be discussed.
Hans A Buller - One of the best experts on this subject based on the ideXlab platform.
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Lactose intolerance and Lactase deficiency in children
Current Opinion in Pediatrics, 1994Co-Authors: Edmond H. H. M. Rings, Richard J Grand, Hans A BullerAbstract:The term Lactase deficiency is widely used to indicate a low or absent level of Lactase enzyme in the small intestine, leading to lactose intolerance. This term is correctly used when the intestinal mucosa is damaged and results in secondary Lactase deficiency. In the case of the genetically determined decrease of Lactase activity during childhood, however, low Lactase levels suggest that the majority of the world's population is "abnormal," whereas individuals from caucasian extraction with high levels of Lactase enzyme throughout life are then considered "normal." It would be better to ascribe racial and ethnic lactose malabsorption as the result of genetically determined reduction of Lactase activity, rather then implying an "abnormality" by the term, "deficiency." Recent studies reveal that this genetic control is at the transcriptional level. The symptomatology of lactose intolerance varies widely, and the diagnostic method of choice is the lactose breath hydrogen test in combination with clinical findings, although small intestinal biopsies should be performed when mucosal diseases are suspected. Treatment of lactose intolerance depends on the age of the child. In young infants complete restriction of lactose containing foods is rarely necessary.
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lactose intolerance and the genetic regulation of intestinal Lactase phlorizin hydrolase
The FASEB Journal, 1991Co-Authors: Robert K. Montgomery, Edmond H. H. M. Rings, Hans A Buller, Richard J GrandAbstract:Lactase-phlorizin hydrolase, which hydrolyzes lactose, the major carbohydrate in milk, plays a critical role in the nutrition of the mammalian neonate. Lactose intolerance in adult humans is common, usually due to low levels of small intestinal Lactase. Low Lactase levels result from either intestinal injury or (in the majority of the world's adult population) alterations in the genetic expression of Lactase. Although the mechanism of decreased Lactase levels has been the subject of intensive investigation, no consensus has yet emerged. Recent studies have begun to define the cellular and molecular biology of this enzyme. In animals and humans, a glycosylated precursor is proteolytically cleaved to yield the mature enzyme on the microvillus membrane of the enterocyte, bound to the lipid bilayer only by a hydrophobic anchor sequence. The enzyme hydrolyzes lactose, phlorizin, and glycosylceramides. A decline in Lactase specific activity occurs at the time of weaning in most mammalian species; in most humans...
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Clinical aspects of lactose intolerance in children and adults.
Scandinavian Journal of Gastroenterology, 1991Co-Authors: Hans A Buller, Robert K. Montgomery, Edmond H. H. M. Rings, Richard J GrandAbstract:The principal carbohydrate of human milk is the disaccharide lactose. In human and all mammalian species, lactose is hydrolyzed in the small intestine by Lactase-phlorizin hydrolase, also abbreviated as Lactase. The absence of Lactase results in the passage of undigested lactose into the large intestine and is associated with a well-known clinical syndrome: lactose intolerance. Low Lactase levels result either from intestinal injury or, as in the majority of world's adult population, from alterations in the genetic expression of Lactase. In this review terminology, pathophysiology, symptoms, diagnostic procedures, and therapy of lactose intolerance will be discussed.
Gareth Parkes - One of the best experts on this subject based on the ideXlab platform.
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review article lactose intolerance in clinical practice myths and realities
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Miranda Lomer, Jeremy D Sanderson, Gareth ParkesAbstract:Summary Background Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance. Aims To review current clinical practice and identify published literature on the management of lactose intolerance. Methods PubMed was searched using the terms lactose, Lactase and diet to find original research and reviews. Relevant articles and clinical experience provided the basis for this review. Results Lactose is found only in mammalian milk and is hydrolysed by Lactase in the small intestine. The Lactase gene has recently been identified. ‘Wild-type’ is characterized by Lactase nonpersistence, often leading to lactose intolerance. Two genetic polymorphisms responsible for persistence have been identified, with their distribution concentrated in north Europeans. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms. Conclusion In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction.
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Review article: lactose intolerance in clinical practice – myths and realities
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Miranda Lomer, Gareth Parkes, Jeremy D SandersonAbstract:Summary Background Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance. Aims To review current clinical practice and identify published literature on the management of lactose intolerance. Methods PubMed was searched using the terms lactose, Lactase and diet to find original research and reviews. Relevant articles and clinical experience provided the basis for this review. Results Lactose is found only in mammalian milk and is hydrolysed by Lactase in the small intestine. The Lactase gene has recently been identified. ‘Wild-type’ is characterized by Lactase nonpersistence, often leading to lactose intolerance. Two genetic polymorphisms responsible for persistence have been identified, with their distribution concentrated in north Europeans. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms. Conclusion In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction.
