Lactose Intolerance Test – Methods and Procedure
The lactose intolerance test is a diagnostic procedure used to determine whether a person is unable to properly digest lactose, the sugar found in milk and dairy products.
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The lactose intolerance test is a diagnostic procedure used to determine whether a person is unable to properly digest lactose, the sugar found in milk and dairy products.
What is the Lactose Intolerance Test?
The lactose intolerance test is a diagnostic method used to determine whether a person suffers from lactose intolerance, a condition in which the body does not produce enough of the enzyme lactase to break down lactose (milk sugar) in the small intestine. When lactose is not properly digested, it passes into the large intestine where it is fermented by bacteria, causing typical digestive symptoms.
When is the Test Recommended?
A lactose intolerance test is recommended when the following symptoms occur after consuming dairy products:
- Bloating and flatulence
- Abdominal cramps and pain
- Diarrhea or loose stools
- Nausea
- Feeling of fullness
The test should always be performed in consultation with a healthcare professional to rule out other conditions such as irritable bowel syndrome or celiac disease.
Types of Lactose Intolerance Tests
Hydrogen Breath Test (H2 Breath Test)
The hydrogen breath test is the most commonly used method. After drinking a lactose solution, the concentration of hydrogen in the breath is measured at regular intervals. If lactose is fermented by bacteria in the large intestine, hydrogen (H2) is produced and exhaled through the lungs. An elevated H2 level indicates lactose intolerance. The test typically takes 2 to 3 hours.
Blood Sugar Test (Lactose Tolerance Test)
In the blood sugar test, blood glucose levels are measured at intervals after drinking a lactose solution. If lactose is digested normally, blood sugar rises. If blood sugar remains low, lactose intolerance is likely. This method is less commonly used than the breath test.
Genetic Test
The genetic test analyzes a blood or saliva sample for gene variants associated with reduced lactase activity. It provides information about primary lactose intolerance but cannot rule out a secondary form of the condition.
Small Intestine Biopsy
In rare cases, a small intestine biopsy may be performed, in which tissue is taken from the small intestine and analyzed for lactase activity. This is an invasive procedure and is only used when other test results are inconclusive.
Self-Test / Elimination Diet
As a first step, an elimination diet can be used: dairy products are completely removed from the diet for two to four weeks. If symptoms disappear, lactose intolerance is likely. However, this approach does not replace a medical diagnosis.
Preparation for the Test
For the hydrogen breath test and the blood sugar test, a fasting period of at least 8 to 12 hours is generally required. Antibiotics, laxatives, and certain medications can affect test results and should be discussed with a doctor beforehand. Smoking before the test can also distort results.
Interpreting the Results
A positive test result confirms lactose intolerance. Depending on the severity, it is recommended to reduce or eliminate lactose from the diet. Many individuals can tolerate small amounts of lactose without symptoms. Lactase enzyme supplements can help people continue to enjoy dairy products. Personalized dietary counseling is strongly recommended.
References
- World Gastroenterology Organisation (WGO): Global Guidelines -- Lactose Intolerance, 2023. Available at: www.worldgastroenterology.org
- Lomer MC, Parkes GC, Sanderson JD. Review article: lactose intolerance in clinical practice -- myths and realities. Aliment Pharmacol Ther. 2008;27(2):93-103.
- Misselwitz B, Butter M, Verbeke K, Fox MR. Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management. Gut. 2019;68(11):2080-2091.
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