{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:40:54Z","timestamp":1788327654851,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,12,5]],"date-time":"2013-12-05T00:00:00Z","timestamp":1386201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2014,2]]},"abstract":"Summary<\/jats:title>\n \n Background<\/jats:title>\n \n Irritable bowel syndrome patients with diarrhoea (\n IBS<\/jats:styled-content>\n \u2010D) often report intolerance to milk; however, the mechanism underlying these symptoms is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n \n To assess the role of psychological factors, immune activation and visceral sensitivity on the development of lactose intolerance (\n LI<\/jats:styled-content>\n ) in\n IBS<\/jats:styled-content>\n \u2010D patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Fifty\u2010five\n IBS<\/jats:styled-content>\n \u2010D patients and 18 healthy controls (\n HC<\/jats:styled-content>\n s) with lactase deficiency underwent a 20\u2010g lactose hydrogen breath test (\n LHBT<\/jats:styled-content>\n ). Patients were categorised as lactose malabsorption (\n LM<\/jats:styled-content>\n ; malabsorption only) or\n LI<\/jats:styled-content>\n [malabsorption plus increase in total symptom score (\n TSS<\/jats:styled-content>\n ). Measurements included (i) psychological status; (ii) enteric biopsies with quantification of mast cells (\n MC<\/jats:styled-content>\n s), T\u2010lymphocytes and enterochromaffin cells; (iii) serum cytokines; (iv) rectal sensitivity before and after lactose ingestion.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n LI<\/jats:styled-content>\n was more prevalent in\n IBS<\/jats:styled-content>\n \u2010D patients than\n HC<\/jats:styled-content>\n s [25\/55 (46%) vs. 3\/18 (17%),\n P<\/jats:italic>\n \u00a0=\u00a00.029].\n IBS<\/jats:styled-content>\n \u2010D patients with\n LI<\/jats:styled-content>\n had (i) higher levels of anxiety than those with\n LM<\/jats:styled-content>\n (\n P<\/jats:italic>\n \u00a0=\u00a00.017) or\n HC<\/jats:styled-content>\n s (\n P<\/jats:italic>\n \u00a0=\u00a00.006); (ii) increased mucosal\n MC<\/jats:styled-content>\n s compared with\n LM<\/jats:styled-content>\n (\n P<\/jats:italic>\n \u00a0=\u00a00.006) and\n HC<\/jats:styled-content>\n s (\n P<\/jats:italic>\n \u00a0<\u00a00.001); (iii) raised serum\n TNF<\/jats:styled-content>\n \u2010\n \u03b1<\/jats:italic>\n compared with\n LM<\/jats:styled-content>\n (\n P<\/jats:italic>\n \u00a0=\u00a00.034) and\n HC<\/jats:styled-content>\n s (\n P<\/jats:italic>\n \u00a0<\u00a00.001) and (iv) increased rectal sensitivity after lactose ingestion compared with\n LM<\/jats:styled-content>\n (\n P<\/jats:italic>\n \u00a0<\u00a00.001) or\n HC<\/jats:styled-content>\n s (\n P<\/jats:italic>\n \u00a0<\u00a00.001). Severity of abdominal symptoms after lactose ingestion was associated with the increase in visceral sensitivity after lactose intake (\n r<\/jats:italic>\n \u00a0=\u00a00.629,\n P<\/jats:italic>\n \u00a0<\u00a00.001),\n MC<\/jats:styled-content>\n s (\n r<\/jats:italic>\n \u00a0=\u00a00.650,\n P<\/jats:italic>\n \u00a0<\u00a00.001) and anxiety (\n r<\/jats:italic>\n \u00a0=\u00a00.519,\n P<\/jats:italic>\n \u00a0<\u00a00.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n IBS<\/jats:styled-content>\n \u2010D patients with lactose intolerence are characterised by anxiety, mucosal immune activation and increased visceral sensitivity after lactose ingestion. The presence of these biomarkers may indicate an\n IBS<\/jats:styled-content>\n phenotype that responds to dietary therapy and\/or mast cell stabilisers (ClinicalTrials.gov Identifier: NCT01286597).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.12582","type":"journal-article","created":{"date-parts":[[2013,12,5]],"date-time":"2013-12-05T21:42:52Z","timestamp":1386279772000},"page":"302-311","source":"Crossref","is-referenced-by-count":86,"title":["Lactose intolerance in irritable bowel syndrome patients with diarrhoea: the roles of anxiety, activation of the innate mucosal immune system and visceral sensitivity"],"prefix":"10.1111","volume":"39","author":[{"given":"J.","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou China"},{"name":"Department of Gastroenterology The First People's Hospital of Hangzhou Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Fox","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology University Hospital Z\u00fcrich Z\u00fcrich Switzerland"},{"name":"NIHR Nottingham Digestive Diseases Biomedical Research Unit Queen's Medical Centre Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Cong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Fried","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology University Hospital Z\u00fcrich Z\u00fcrich Switzerland"},{"name":"Z\u00fcrich Centre for Integrative Human Physiology (ZIHP) University of Z\u00fcrich Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou 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