Abstract
The role of dairy foods in the continued symptomatology of patients with IBD is unclear. This is in part due to limited data on epidemiology of lactose intolerance (LI) in IBD. We sought to utilize a large population based database to evaluate the prevalence of LI in IBD.
We queried a commercial database (Explorys Inc, Cleveland, OH), an aggregate of Electronic Health Record data from 26 major integrated healthcare systems in the US from 1999 to 2019. We identified an aggregated patient cohort of eligible patients with a diagnosis of “Crohn’s disease” (CD) and “Ulcerative Colitis” (UC) between June 2014 and 2019, based on Systematized Nomenclature Of Medicine – Clinical Terms. We calculated the prevalence LI in IBD overall, and among different age, race and gender based sub-groups and identified risk factors for LI in IBD.
Of the 35,521,930 individuals in the database from October 2014–2019, we identified 165,750 and 140,640 individuals with a diagnosis of CD and UC with overall prevalence rates of 0.47% and 0.4% respectively. The prevalence of LI in individuals without IBD was 0.2%. Compared to individuals without IBD, the prevalence of LI in CD was increased at 0.9% [OR: 4.56, 95% CI: 4.33–4.81, p<0.0001] and prevalence of LI in UC was increased at 0.8% [OR: 4.03, 95% CI: 3.80–4.28, p<0.0001] (Figure 1).
Overall, Age-based, Gender-based and Race-based Prevalence (%) of Lactose Intolerance (LI) in Crohn’s Disease (CD) and Ulcerative Colitis (UC) in the United States between 2014 and 2019
The prevalence of LI in CD was increased in: females at 0.98% vs males at 0.77% [OR: 1.27, 95% CI: 1.14–1.41, p<0.0001]; African-Americans at 1.52% vs Caucasians at 0.87% [OR: 1.73, 95% CI: 1.50–2.00, p<0.0001] and children (<18yo) at 2.39% vs adults (≥18yo) at 0.88% [OR: 2.77, 95% CI: 2.13–3.60, p<0.0001].
The prevalence of LI in UC was increased in: females at 0.91% vs males at 0.64% [OR: 1.41, 95% CI: 1.25–1.60, p<0.0001]; African-Americans at 1.45% vs Caucasians at 0.78% [OR: 1.84, 95% CI: 1.55–2.19, p<0.0001] and children (<18yo) at 1.8% vs adults (≥18yo) at 0.79% [OR: 2.28, 95% CI: 1.46–3.57, p=0.0003].
This is one of the first large studies to date that has described the prevalence of LI in IBD in the United States. We found that the prevalence of LI to be increased nearly 4-fold in IBD. We recommend screening for LI in IBD patients with active symptoms to delineate active disease from symptomatology due to LI.
