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Evaluate lactose intolerance, malabsorption syndromes. May be abnormal with Crohn's disease, small bowel resections, jejunitis, Giardia lamblia infestation, Whipple disease, and cystic fibrosis.
Lactose is a disaccharide digested by lactase. It yields glucose and galactose. The latter is converted to glucose by the liver after its absorption. Glucose is measured and it is the increase or lack of increase over the fasting specimen that is used for interpretation. A normal response will show a glucose increase >30 mg/dL over the baseline sample. Those with lactase deficiency will demonstrate bloating, cramps, and diarrhea and will show a glucose increase <20 mg/dL. Diabetic patients may have abnormal lactose tolerance curves due to abnormal carbohydrate metabolism and not necessarily due to lactose intolerance. Since 25% of normal individuals have flat glucose tolerance tests, it has been suggested that patients with flat lactose tolerance tests should also have a glucose tolerance test. Ethanol can prevent conversion of galactose to glucose by the liver; thus, blood or urine galactose can be measured.
