PREVALANCE AND MANAGEMENT OF LACTOSE INTOLERANCE IN PATIENTS WITH DIARRHOEL IRRITABLE BOWEL SYNDROME IN GASTROENTEROLOGY DEPARTMENT OF A TERTIARY CARE HOSPITAL.

*Mohd Aqib Nizami, Amair Ali Hashmi, Mohd Ghous Uddin, Mohd Akbar, Syed Aamir Ali and Syed Ibrahim Hasan

ABSTRACT

Background: Irritable bowel syndrome (IBS) is a common and global gastrointestinal disorder. Diarrhea-predominant IBS (IBS-D), a subtype of IBS which can present some similar symptoms with lactose intolerance (LI) such as abdominal pain, bloating, flatulence, and diarrhea. The prevalence of LI in patients with D-IBS is unclear. In many cases due this overlapping of symptoms most of the patients with LI are mistaken for D-IBS And receive inappropriate treatment. Moreover, in developing countries like India, LI is considered as minor clinical importance. Hence we proposed a hypothesis, to assess the prevalence of LI in D-IBS and its management. Objective: Our objective is to find the prevalence of LI in D-IBS and to achieve the effective management strategies for LI. Materials and Methods: This is a prospective observational study carried out at the Gastroenterology O.P Department of Princess Esra Hospital, Owaisi group of hospitals Hyderabad for 6 months. We recruited 65 D-IBS patients after the informed consent and Institutional Ethics Committee approval. We determine the prevalence of LI in D-IBS. We used EXCEL to carry out CHI-square, Odds ratio, Mean and Standard Deviation at P=0.05 to identify the association of Age, Gender and other factors causing LI. External lactase enzyme supplement in the name of YAMOO was given to LI positive patients and they were followed up for a period of 10 days. Result: Our study revealed that the prevalence of LI was found to be 43% (28 subjects OUT OF 65 subjects) in D-IBS patients. The prevalence was 1.69 times higher in females compared to that of male, the risk was found to be 3.63 times higher in the age group between 60-80 years which were statistically not significant. External lactase enzyme supplement was given to LI positive patient's, in whom symptoms such as abdominal pain, diarrhea, bloating and flatulence were significantly reduced indicates the effectiveness of YAMOO in treatment of LI. Conclusion: The prevalence of LI was found to be higher in female than in male and considerably higher risk was in age group between 60-80 years. Treatment is relatively simple and aimed at reducing or eliminating the dairy products which may result in deficiency of calcium and other nutritional requirement, hence our study conclude management of LI with external lactase enzyme supplement(yamoo) is effective and eliminating the consequences that may occur due to elimination of dairy products from diet.

Keywords: Diarrheal-Irritable bowel syndrome, lactose intolerance, observational study, yamoo.