Case history
Case history
A 25-year-old woman presents with a 10-year history of intermittent diarrhoea, bloating, abdominal pain, and flatulence. Recently her symptoms have become worse. She thinks the change in symptoms may be related to her increased intake of milk over the last few months. Previously, she consumed moderate amounts of dairy produce, but little milk. She has a past history of eczema and asthma (takes salbutamol inhalers as needed) and was diagnosed with irritable bowel syndrome (IBS) by her family physician several years ago. Family history reveals that her only sister has been diagnosed with IBS and lactose intolerance. Abdominal examination reveals a slightly distended abdomen. Results of faecal testing for occult blood are negative.
Other presentations
Other, less common presentations include constipation, vomiting, faltering grwoth (especially with congenital lactase deficiency), and increased frequency of associated systemic symptoms.[1] Systemic symptoms are more common in adults. Limited evidence suggests that systemic symptoms include headache, poor short-term memory, severe tiredness, joint pain, muscle pain, eczema, mouth ulceration, arrhythmia, and asthma.[1]
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