Does avoiding milk products improve diarrhea in men with human immunodeficiency virus disease?

A single glass of milk does not cause diarrhea in men with chronic diarrhea associated with human immunodeficiency virus (HIV) disease. It follows, but hasn't yet been proved, that moderate amounts of milk, over time, will not worsen diarrhea. (LOE = 1b)

Tinmouth J, Kandel G, Tomlinson G, Walmsley S, Steinhart AH, Glazier R. The effect of dairy product ingestion on human immunodeficiency virus-related diarrhea in a sample of predominantly gay men: a randomized, controlled, double-blind, crossover trial. Arch Intern Med 2006;166:1178-1183.  [PMID:16772244]

Cross-over trial (randomized)

Foundation

Outpatient (any)

Patients with HIV-related chronic diarrhea are often told to avoid milk, especially if they are known to be lactase deficient. The researchers enrolled 49 HIV-infected adults (1 woman; 92% white) who reported at least 3 loose or watery bowel movements per day for at least 4 weeks. After ruling out microbiologic causes and determining lactase deficiency status, the patients were randomly given 8 ounces (240 mL) of semi-skimmed (2%) milk with or without lactose. The patients were then given the opposite formulation of milk 1 to 6 weeks later, so that each subject served as his or her own control regarding the effect of lactose. On each study day, the subjects were monitored for symptoms and bowel movements for the 8 hours after milk ingestion. Stool output and the number of bowel movements was similar on the 2 days. Symptoms -- a combination of abdominal bloating, flatulence, pain, and diarrhea -- were measured using a scale of 0 to 5 with a maximum score of 20. Symptom scores were similar during the lactose and lactose-free study days (4.7 and 5.5; P= NS). In the lactase-deficient group, symptom scores did not vary between the lactose days and the lactose-free days.