Lactose digestion

Dairy products and IBD: avoiding them may not be necessary


Many people with Inflammatory Bowel Disease (IBD) report that their symptoms become worse after consuming dairy products. However, research about food and IBD is controversial. A new meta-analysis investigated the lactose maldigestion prevalence in IBD.

Many people with Crohn’s disease (CD) or Ulcerative Colitis (UC) avoid dairy out of fear that it will cause uncomfortable symptoms, such as excess gas, abdominal cramping, and diarrhea. However, not every person with CD or UC is actually lactose maldigester or lactose intolerant, so avoiding all dairy may not be a good option. It could even be counterproductive, because dairy is an excellent source of calcium. This is a particularly important nutrient for people with Crohn’s disease, as certain drug treatments and malabsorption may cause a calcium deficiency.  This literature review was performed to extract data on lactose maldigestion prevalence in IBD.

Dairy restrictions may adversely affect disease outcome

Among 1022 articles evaluated, 17 were included in meta-analysis. Lactose maldigestion in inflammatory bowel disease seems to be determined by ethnicity  in most cases of UC and CD. Intolerance symptoms depend on several parameters besides lactose maldigestion. The study also indicates that dairy foods may protect against IBD. Nutritional consequences of dairy restrictions might therefore impact adversely on bone and colonic complications. Even if someone with IBD is lactose intolerant, it’s also possible to safely consume certain dairy products that contain very little lactose or can digest it. These include fermented dairy products like yogurt.

The authors conclude that further work is needed to evaluate the role of dairy foods in IBD as well on methods to avoid their restriction.

Source: Andrew Szilagyi et al., Nutrition Journal 2016; 15 :67.