Influence of the pharmacological modification of gastric emptying on lactose digestion and gastrointestinal symptoms

Background: In lactose maldigesters the ingestion of food which retards gastric emptying improves tolerance to lactose. Aim: To study the effects of the pharmacological modification of gastric emptying on the speed of development of lactose‐induced symptoms. Methods: After an overnight fast, 18 lactose maldigesters were given, in a randomized double‐blind study design at 1‐week intervals, either propantheline (as bromide 15 mg), metoclopramide (as hydrochloride 10 mg) or placebo, in identical capsules, 60 min before ingesting 50 g lactose coloured with 1 g carmine dye (to measure gastrointestinal transit time). Gastrointestinal symptoms, urinary galactose excretion, and breath hydrogen and blood glucose concentrations were recorded. Results: The propantheline‐induced prolongation of gastric emptying improved tolerance to lactose, as measured by reduced area under the gastrointestinal symptom score curve 0–12 h, compared to placebo (by 26%) (P