Written by Greg Arnold, DC, CSCS. Compared to the control group, healthy, lactose-intolerant volunteers who supplemented 4 weeks with L. acidophilus DDS-1, significantly improved their symptoms of diarrhea, vomiting and abdominal cramping during an acute 6 hour lactose challenge. 

lactose freeLactose intolerance is a condition where the body is unable to digest all of the lactose that is ingested through dairy products. Lactose intolerance is not a serious medical condition but it can have a significant effect on quality of life. The symptoms of lactose intolerance include diarrhea, flatulence, abdominal cramping, audible bowel sounds, and vomiting (1).

The current medical approach to lactose intolerance is decreasing or eliminating dairy product consumption from the diet (2). However, dairy products are known to be excellent sources of calcium, potassium, vitamin D, B vitamins and high quality protein, and avoiding dairy products has been shown to increase the risk for bone fracture and osteoporosis (3). Therefore, finding a way to maintain dairy product consumption while limiting the symptoms of lactose intolerance is needed.

Now a new study (4) suggests that taking probiotics may benefit those with lactose intolerance. The study involved 38 healthy volunteers aged 18 to 75 with lactose intolerance. They were given either a probiotic supplement containing a special strain of L. acidophilus (called “DDS-1 strain = 20 subjects) or a placebo (sugar tablet = 18 subjects) for four weeks.

Before and after the four-week supplementation period, each subject underwent a six-hour lactose challenge during which they consumed 480 milliliters of milk. They recorded their symptoms during the six hours with a validated symptom score questionnaire consisting of six abdominal-related items: diarrhea, abdominal cramping, vomiting, audible bowel sounds, flatulence, and overall symptoms. The 480-mL amount was used as it “closely reflects the average amount of milk consumed by the population” (6).

The DDS-1 probiotic supplement was taken every morning with food and contained 10 billion colony-forming units per capsule. The researchers used the DDS-1 strain because it has been proven “to be superior to other strains of lactobacillus in the ability to establish in the human gastrointestinal (GI) tract” (5). After four weeks, there was a four-week washout period after which the subjects switched to the other supplement for another four weeks.

The researchers noted a significant benefit in the probiotic group compared to the placebo group with the six-hour lactose challenge. Specifically:

  • 20.8% improved diarrhea symptoms (1.34 versus 1.69, p = 0.033)
  • 18.9% less abdominal cramping (1.94 versus 2.39, p = 0.012)
  • 78.8% less vomiting (0.08 versus 0.36, p = 0.0002)
  • 11.8% lower overall symptom score (9.28 versus 10.51, p = 0.037)

Statistical significance was not reached between the groups for audible bowel sounds (p = 0.589) or flatulence (p = 0.770). No adverse events were recorded in either group.

Although admitting that the short supplement period of four weeks was “a major limitation” as “extension of both active and placebo groups may have demonstrated a more significant improvement in the 6-hour lactose challenge symptom score after prolonged use”, the researchers concluded that “this unique DDS-1 strain of Lactobacillus acidophilus is safe to consume and improves abdominal symptom scores compared to placebo with respect to diarrhea, cramping, and vomiting during an acute lactose challenge.”

Source: Pakdaman MN. The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance – a randomized, double-blind, placebo-controlled, crossover clinical trial. Nutr J. 2016 May 20;15(1):56. doi: 10.1186/s12937-016-0172-y

© Pakdaman et al. 2016

Posted July 19, 2016.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY.  You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.

References:

  1. “Lactose intolerance” posted on the NIH website
  2. Shaukat A, Levitt MD, Taylor BC, MacDonald R, Shamliyan TA, Kane RL, Wilt TJ. Systematic review: effective management strategies for lactose intolerance. Ann Intern Med. 2010;152:797–803.
  3. Pakdaman MN. The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance – a randomized, double-blind, placebo-controlled, crossover clinical trial. Nutr J. 2016 May 20;15(1):56. doi: 10.1186/s12937-016-0172-y
  4. Latorre G, Besa P, Parodi CG, Ferrer V, Azocar L, Quirola M, Villarroel L, Miquel JF, Agosin E, Chianale J. Prevalence of lactose intolerance in Chile: a double-blind placebo study. Digestion. 2014;90:18–26.
  5. Frese SA, Hutkins RW, Walter J. Comparison of the colonization ability of autochthonous and allochthonous strains of lactobacilli in the human gastrointestinal tract. Adv Microbiol. 2012;2:399
  6. Di Stefano M, Veneto G, Malservisi S, Cecchetti L, Minguzzi L, Strocchi A, Corazza GR. Lactose malabsorption and intolerance and peak bone mass. Gastroenterology. 2002;122:1793–9.