Case history
Case history
A 25-year-old African-American woman presents with a decade-long history of intermittent diarrhea, 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 used to consume moderate amounts of dairy produce but only a little milk. She has a past history of eczema and asthma (takes salbutamol inhalers as needed) and was diagnosed with irritable bowel syndrome by her family physician several years ago. Family history reveals her only sister has been diagnosed with irritable bowel syndrome and lactose intolerance. Abdominal exam reveals a slightly distended abdomen. Results of fecal testing for occult blood are negative.
Other presentations
Other, less common presentations include constipation, vomiting, faltering growth (especially with congenital lactase deficiency), and increased frequency of associated systemic symptoms.[1] Systemic symptoms are more common in adults. Limited evidence suggests 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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