Purpose: to define the frequency of secondary lactase deficiency (SLD) in patients with postinfectious IBS and to develop therapy for the correction of mild SLD in adult patients.
Methods and materials: In this study, 138 patients (the mean age - 33.9 +/- 9.09; F/M - 112/26) with postinfectious IBS were analyzed concerning lactase deficiency. All patients underwent intestinal endoscopy with biopsies from the mucosa of the descending duodenum in order to determine lactase deficiency twice before and after therapy. To diagnose small intestinal bacterial overgrowth (SIBO) all patients underwent lactulose breath test during 2 hours.
Results: SLD was detected in 59.4% of patients with postinfectious IBS. Mild SLD was determined in 43.5% of patients, and severe SLD - in 15.9% of patients. SLD in all cases was accompanied by SIBO (the mean level of lactulose breath test was 101 +/- 37 ppm, N<20 ppm). In group patients who took the probiotic during 14 days in 70.8% of patients recovering of lactose metabolism in the small intestine and decreasing of the intensity of clinical symptoms were registered. The decrease of the lactulose breath test level (86.9 +/- 40.9 ppm; 17.4 +/- 6.6 ppm; p<0.01) and negative LQT (p<0.01) were registered in the first group. In group patients who took placebo during 14 days there was no positive effect in 68.4% of cases.
Conclusion: the probiotic Bifiform, composed of Bifidobacterium longum 10(7) and Enterococcus faecium 10(7), demonstrated efficiency in correction of mild SLD in patients with postinfectious IBS and can be used to prevent SIBO.