Breath Hydrogen Test and Stools Characteristics After Ingestion of Milk and Yogurt in Malnourished Children with Chronic Diarrhoea and Lactase Deficiency

Abstract

Yogurt may be proposed as a substitute for milk in the diet of children with chronic diarrhoea and lactase deficency because of its nutritional similarity to milk and its property of preventing lactose malabsorption in lactase deficient adults. The aim of the present study was to compare the absorption of lactose and the clinical tolerance after ingestion of milk and yogurt. Nine Algerian boys, aged 7-29 months, with chronic diarrhoea, jejunal villous atrophy, and lactase deficiency, received a diagnostic load of lactose in water, and on the following days, in random order, milk or yogurt. These loads provided 2, 1.8, and 0.9 g lactose/kg body weight, respectively. Lactose malabsorption was defined by a rise in hydrogen concentration in expired air by at least 20 ppm above basal level. It was more frequent after lactose and milk than after yogurt (n = 8, 8, and 3, respectively; NS). Less H2 was produced after ingestion of yogurt than after lactose and milk. Areas under the curve for H2 were 1092 .+-. 233 vs 6950 .+-. 1963 ppm, 3 hours after yogurt and lactose, respectively (P < 0.01). Faecal output was 100.0 .+-. 31.0 109.5 .+-. 38.7 and 57.0 .+-. 29.0 g, 8 hours after lactose, mild and yogurt, respectively. Acid (pH < 5.0), watery stools containing reducing substances (> 2.5 g/l), defining lactose intolerance, were observed in three and one children after lactose and milk, but were absent after yogurt (P < 0.01). These results showed that absorption of lactose was better after ingestion of yogurt than after milk and suggested that diarrhoea may be improved by the substitution of milk by yogurt. The lower quantity of lactose in the yogurt load, the .beta.-galactosidase activity of yogurt, or possibly both of these mechanisms can account for this improvement.