ArticleDigestion2026
Lactose Sensitivity and Malabsorption in Functional Dyspepsia and Functional Dyspepsia-Irritable Bowel Syndrome Overlap.
Article in Digestion, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionLactose intolerance is frequently suspected in disorders of gut-brain interaction, yet symptoms often do not align with objective malabsorption. While lactose-related symptoms have been investigated in irritable bowel syndrome (IBS), data on functional dyspepsia (FD), particularly patients with overlapping IBS, remain limited. This study examined the relative contribution of lactose sensitivity and lactose malabsorption to symptom burden, and evaluated whether FD-IBS overlap is associated with greater symptom severity than FD alone.
methodsIn this cross-sectional study, adults underwent standardized lactose hydrogen breath and symptom testing. Diagnoses followed Rome IV criteria. Lactose malabsorption was defined as ≥20 ppm hydrogen increase; lactose sensitivity as ≥20 mm rise on the adult Carbohydrate Perception Questionnaire. Group differences were tested non-parametrically; adjusted effects used a general linear model with age and gender.
resultsAmong 587 patients, lactose sensitivity was more prevalent than lactose malabsorption (54.9% versus 41.2%; p < 0.001) and occurred more frequently in patients with FD-IBS overlap than in those with FD alone (69.8% versus 52.7%; p < 0.001). Patients with overlap exhibited the highest symptom burden (p < 0.001). In multivariate analysis, lactose sensitivity and younger age were independently associated with FD-IBS overlap, whereas lactose malabsorption and gender were not.
conclusionLactose sensitivity, not malabsorption, was closely associated with symptom burden in patients with FD. FD-IBS overlap was linked to amplified burden, underscoring the importance of validated symptom assessment alongside breath testing for diagnostic precision.
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