Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not preprandial oral lactase supplement reduces abdominal pain in lactose-intolerant adult patients after a lactose-containing meal.

STUDY DESIGN: A systematic review of three randomized, blinded, controlled primary research studies published between the years of 2010 and 2018.

DATA SOURCES: One randomized controlled trial (RCT), one randomized comparative study, and one randomized crossover study evaluating the efficacy of 9,000 units of preprandial oral lactase supplement in reducing abdominal pain due to lactose intolerance (LI). All studies were published in peer-reviewed journals and found via the use of PubMed, Elsevier, and OVID. The particular articles were selected based on their novelty and relevance to the clinical question.

OUTCOMES MEASURED: LI patients used a visual analogue scale questionnaire and maintained a diary to report the severity of their symptoms, tolerability, and adverse events. Clinical investigators evaluated compliance and calculated a symptom score.

RESULTS: Ojetti et al. reported a large reduction in abdominal pain in the tilactase group comparing to the placebo group. De Vrese et al. found no significant reduction in abdominal pain with Aspergillus oryzae lactase treatment. Francesconi et al. proved an experimental Perlatte® to be non-inferior to a commercially available Lactaid®, however, the difference between the two products was not statistically significant.

CONCLUSIONS: The evidence presented in this review is conflicting as to whether or not preprandial oral lactase supplement reduces abdominal pain in LI adult patients after a lactosecontaining meal. The future research should consider genetic testing of the participants and distinguishing subjective lactose intolerance symptoms from a true lactase deficiency