Gastrointestinal symptoms related to the consumption of high fermentable sugars (FODMAPs) in individuals with self-perceived dairy product intolerance

Abstract

Abstract Background: Lactose malabsorption is frequent in Mexico. Foods high in content of fermentable sugars (FODMAPs) –including lactose– cause symptoms in persons with gastrointestinal disorders. We describe the relation of sugar intake to gastrointestinal symptoms, in individuals with self-perceived intolerance to dairy products. Methods: A cross-sectional survey with a sampling at convenience on symptom frequency and intensity, caused by dairy product and FODMAP (other than lactose) intake was applied to 823 consecutive participants seen for a gastroenterology consultation. Patients were divided into two groups: 1) self-perceived dairy product intolerance (SPDPI) and 2) self-perceived dairy product tolerance (SPDPT). Differences between groups were compared, utilizing hypothesis tests, and correlations were determined, using the Spearman’s rho test. Results: A total of 464 (56%) participants fit the SPDPI definition, presenting with symptoms for more days (3 vs 1, p=0.0001) and of greater intensity (5 vs 1, p=0.0001), as well as with a higher symptom score upon FODMAP (other than lactose) intake, compared with the SPDPT subjects. The correlation between frequency and intensity was statistically significant (r= 0.618, p= 0.001), albeit moderate. Correlations between symptoms and FODMAPs (identifying oligosaccharides, polyols, and monosaccharides) were very weak. Conclusion: The SPDPI subjects presented with distressing symptoms after ingesting FODMAPs other than lactose.