Introduction: Lactose intolerance is caused by a lack of the enzyme lactase, which is responsible for hydrolysing lactose into its monosaccharide components for quick absorption in the small intestine. The most frequent or primary cause of malabsorption is lactase non-persistence, also known as adult-type hypolactasia, and the secondary causes are due to diseases of the mucosa of the small intestine, such as celiac disease, gastroenteritis, or Crohn’s disease, which may involve a transitory intolerance to lactase. The prevalence of hypolactasia is high and depends on the geographic area, ranging from percentages of 5% in north-west Europe, through to nearly 100% in some Asian countries.Today, a variety of tests are available to detect lactase deficiency. However, in terms of diagnosing lactose intolerance itself, these tests are less precise, and require a simultaneous evaluation of poor lactose digestion, and the existence of gastrointestinal symptoms.
Aims. To locate scientific evidence on the sensitivity and specificity, use, indications, adverse effects, and costs of the H2 breath test and other alternatives for diagnosing lactose intolerance.
Methods. An exhaustive search of the biomedical literature in March 2017, without any time limit, in the following databases specialising in systematic reviews: HTA (Health Technology Assessment), DARE (Database of Abstracts of Reviews of Effectiveness), NHS EED (Economic Evaluation Database del National Health Service) or the Cochrane Plus library; and general databases such as Medline, Embase, and the ISI database.
Results, discussion, and conclusions: See pdf below
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