Can we shorten the lactose tolerance test?

Abstract

Background: Lactose malabsorption (LM) is a very common problem with high prevalence in Southern Europe. The lactose tolerance test (LTT) is a basic probe, which is widespread in local hospitals, because it requires non-complex and inexpensive infrastructure. The aims of our study are to determine that a reduction in the duration of LTT does not affect its diagnostic accuracy to detect LM and to calculate the savings that this reduction may represent. Methods: A prospective study of consecutive patients who underwent LTT for suspected LM was conducted. We analyzed and compared the clinical results and costs (extraction, analytical measurement, time spent by nursing staff, technicians and patients) of suppressing LTT points at 30 and 120 min. Results: The study included 201 patients. Pathological LTT was found in 119 cases. Eliminating the measurement of glucose at 120 min did not alter the LTT interpretation in any patient; however, up to 18. 4% of patients had a LTT misinterpretation when the 30 min point was suppressed. If the LTT 120 min measurement would have been suppressed, 41 334 euros could have been saved. Conclusions: Suppressing the 120 min LTT point does not imply any changes in clinical results and reduces patient's waiting time; it also benefits the health system by saving time, manpower and materials. © 2014 Macmillan Publishers Limited. All rights reserved.