Predictive Value of Hydrogen/Methane Lactose Breath Testing on the Therapeutic Effect of Lactose-free Diet in Moderate to Severe ROME IV IBS.

Exclusion Criteria

• •Clinical suspicion of an organic disorder different from LI or IBS (patients can be included when this disorder had been excluded);
• •Known lactose intolerance or malabsorption;
• •Known inflammatory bowel disorder;
• •Known intestinal motility disorder;
• •Alcohol (defined as more than 14 U per week) or other substance abuse;
• •Active psychiatric disorder;
• •Known systemic or auto-immune disorder with implication for the GI system;
• •Prior abdominal surgery (with the exception of appendectomy);
• •Any prior diagnosis of cancer other than basocellular carcinoma;
• •Current chemotherapy;
• •History of gastro-enteritis in the past 8 weeks;
• •Intake of antibiotics, pre- or probiotics during the past 8 weeks;
• •Dietary supplements unless taken at a stable dose for more than 8 weeks;
• •Treatment with neuromodulators (one neuromodulator taken at a stable dose for more than 12 weeks is allowed);
• •Treatment with spasmolytic agents, opioids, loperamide, gelatin tannate or mucoprotect-ants during the past 8 weeks;
• •LFD or low FODMAP diet in the past