Clinical Diagnosis

The most common tests used to measure the absorption of lactose in the digestive system are the lactose tolerance test, the hydrogen breath test, and the stool acidity test.

The lactose tolerance test involves an individual drinking a liquid that contains lactose. The individual must fast before this test, in which several blood samples are taken over a two-hour period to measure the blood glucose level, which indicates how well the body is able to digest lactose. If lactose is incompletely absorbed, then the blood glucose level will not rise, confirming a diagnosis of lactose intolerance.

The hydrogen breath test measures the amount of hydrogen in the breath. Normally, no hydrogen is detectable in the breath. However, undigested lactose in the colon is fermented by bacteria, and various gases, including hydrogen, are produced. The hydrogen is absorbed from the intestines, carried through the bloodstream to the lungs, and exhaled. As with the previous test, a lactose-loaded beverage is consumed, and the individual then breathes into a machine that measures the amount of hydrogen in the breath.

The stool acidity test measures the amount of acid in a person's stool. Undigested lactose fermented by bacteria in the colon creates lactic acid and other short-chain fatty acids that can be detected in a stool sample. In addition, glucose may be present in the sample as a result of unabsorbed lactose in the colon.

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