ROSH Gastrointestinal Practice Exam

What is the most appropriate management step for a 19-year-old woman with positive lactose hydrogen breath test?

1. Advise a lactose-restricted diet

2. Computed tomography of the abdomen

3. Endoscopy

4. Symptomatic treatment of diarrhea

The correct answer is: Advise a lactose-restricted diet

The most appropriate management step for a 19-year-old woman with a positive lactose hydrogen breath test is to advise a lactose-restricted diet. A positive hydrogen breath test indicates that the patient is likely lactose intolerant, meaning her body has difficulty digesting lactose, a sugar found in milk and dairy products. Consuming lactose can lead to gastrointestinal symptoms, such as bloating, diarrhea, and abdominal pain. By recommending a lactose-restricted diet, the patient can avoid foods that contain lactose, which should help alleviate her symptoms and improve her quality of life. This dietary adjustment allows the body to avoid the undigested lactose that ferments in the gut, leading to the production of hydrogen gas, which is measured in the breath test. Implementing a lactose-restricted diet is a straightforward and effective first step in managing lactose intolerance, making it the most appropriate choice for this scenario.