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Carbohydrate Malabsorption (carbohydrate + malabsorption)
Selected AbstractsPilot study on the effect of reducing dietary FODMAP intake on bowel function in patients without a colonINFLAMMATORY BOWEL DISEASES, Issue 12 2007Catherine Croagh MB Abstract Background: Poorly absorbed short-chain carbohydrates (FODMAPs) in the diet should, by virtue of their osmotic effects, increase fecal output following colectomy and ileal pouch formation or ileorectal anastomosis (IRA). The aim was to perform a proof-of-concept evaluation of this hypothesis. Methods: Fifteen patients (13 pouch, 2 IRA) had dietary and symptomatic evaluation before and during a low FODMAP diet. Carbohydrate malabsorption was evaluated by breath tests. Pouchitis was assessed clinically/endoscopically or by fecal lactoferrin. Results: Of 8 patients with a breath hydrogen response to lactulose, 7 had fructose malabsorption, 3 with lactose malabsorption, and 1 had lactose malabsorption alone. Five of 7 studied retrospectively improved stool frequency (from median 8 to 4 per day; P = 0.02), this being sustained over 0.5,3 years of follow-up. Five of 8 patients completed a prospective arm of the study. One patient had sustained improvement in stool frequency and 1 had reduced wind production. Overall, none of 8 patients who had pouchitis improved. In contrast, median daily stool frequency fell from 8 to 4 (P = 0.001) in the 7 without pouchitis. The degree of change in FODMAP intake also predicted response. There was a tendency for pouchitis to be associated with low baseline FODMAP intake. Conclusions: There is a high prevalence of carbohydrate malabsorption in these patients. Reduction of the intake of FODMAPs may be efficacious in reducing stool frequency in patients without pouchitis, depending on dietary adherence and baseline diet. (Inflamm Bowel Dis 2007) [source] Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disordersALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2009J. S. BARRETT Summary Background, Fructose malabsorption, lactose malabsorption and an early rise in breath hydrogen after lactulose (ERBHAL) may play roles in induction of symptoms in gastrointestinal conditions. Aim, To compare prevalence and interactions of fructose malabsorption, lactose malabsorption and ERBHAL among healthy subjects and those with chronic intestinal disorders using consistent breath hydrogen testing methodologies. Methods, Consecutive series of Caucasian patients with Crohn's disease (n = 91), ulcerative colitis (56), functional gastrointestinal disorders (FGID) (201), coeliac disease (136) and 71 healthy volunteers underwent breath hydrogen testing using lactulose, fructose and lactose. Results, Early rise in breath hydrogen after lactulose occurred more commonly in healthy controls (39%) than in Crohn's disease (20%) and untreated coeliac disease (14%; P < 0.008), but not FGID (27%), ulcerative colitis (26%) or treated coeliac disease (29%). Fructose malabsorption was more frequent in Crohn's disease (61%) than other groups (33,44%, P < 0.05). Lactose malabsorption was most common in Crohn's disease (42%) and ulcerative colitis (40%) and uncommon (10%) in 79 patients with newly diagnosed coeliac disease. In Crohn's disease, concurrent Fructose malabsorption and lactose malabsorption was most common (29%), and the association of fructose malabsorption with ERBHAL seen overall (62%) was not observed (36%, P < 0.0001). Conclusions, Carbohydrate malabsorption and ERBHAL are normal physiological phenomena. The abnormal patterns observed in Crohn's disease may have pathogenic importance. [source] Pilot study on the effect of reducing dietary FODMAP intake on bowel function in patients without a colonINFLAMMATORY BOWEL DISEASES, Issue 12 2007Catherine Croagh MB Abstract Background: Poorly absorbed short-chain carbohydrates (FODMAPs) in the diet should, by virtue of their osmotic effects, increase fecal output following colectomy and ileal pouch formation or ileorectal anastomosis (IRA). The aim was to perform a proof-of-concept evaluation of this hypothesis. Methods: Fifteen patients (13 pouch, 2 IRA) had dietary and symptomatic evaluation before and during a low FODMAP diet. Carbohydrate malabsorption was evaluated by breath tests. Pouchitis was assessed clinically/endoscopically or by fecal lactoferrin. Results: Of 8 patients with a breath hydrogen response to lactulose, 7 had fructose malabsorption, 3 with lactose malabsorption, and 1 had lactose malabsorption alone. Five of 7 studied retrospectively improved stool frequency (from median 8 to 4 per day; P = 0.02), this being sustained over 0.5,3 years of follow-up. Five of 8 patients completed a prospective arm of the study. One patient had sustained improvement in stool frequency and 1 had reduced wind production. Overall, none of 8 patients who had pouchitis improved. In contrast, median daily stool frequency fell from 8 to 4 (P = 0.001) in the 7 without pouchitis. The degree of change in FODMAP intake also predicted response. There was a tendency for pouchitis to be associated with low baseline FODMAP intake. Conclusions: There is a high prevalence of carbohydrate malabsorption in these patients. Reduction of the intake of FODMAPs may be efficacious in reducing stool frequency in patients without pouchitis, depending on dietary adherence and baseline diet. (Inflamm Bowel Dis 2007) [source] A15. Public attitudes towards the healthiness of fruit juicesJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2000K. I. France Background Fruit juice is a major part of children's diets and accounts for a large proportion of their fruit and vegetable servings. People may confuse fruit juice with fruit drinks. This can cause problems as people could possibly substituting a portion of fruit for a drink, which contains little or no fruit. Studies have shown that excessive consumption of fruit juice can lead to health problems in children, including short stature, obesity, nonorganic failure to thrive and carbohydrate malabsorption. An increase in dental erosion has also been noted which appears to correlate with an increase in fruit juice and carbonated beverage consumption. Aims The aim of this study was to find out what the general public's attitudes are towards the healthiness of fruit juice. Methods A mini focus group and a questionnaire were the methods used for data collection. The subjects were parents of children aged 12 or under in a local primary school. Results Overall, the study group had a poor knowledge of the difference between fruit juice and drinks, and knowledge of sugar content was poor. The group had a good knowledge of fruit content. Fruit juice was regarded as being a health drink. They were unsure if excessive consumption could damage children's health or not. Their main concern was regarding their children's teeth. The factor identified as being most influential when choosing a drink was flavour, followed closely by healthiness. Nutritional knowledge was generally poor. The average daily intake of juice was 650 mL (22.8 floz), considerably more than the value recommended by several experts. Conclusion There is a need for nutritional education regarding the consumption of fruit juice. The public should be made more aware of the potential problems associated with excessive fruit juice consumption without discouraging fruit juice intake altogether, as it is an important source of fruit in the diets of young children. [source] Analysis of the breath hydrogen test for carbohydrate malabsorption: Validation of a pocket-sized breath test analyserJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2000Ws Lee Objective: To assess the validity and clinical application of a hand-held breath hydrogen (H2) analyzer (BreatH2, Europa Scientific, Crewe, UK). Methodology: Breath samples of patients referred to the Gastroenterology Unit, Women's and Children's Hospital, North Adelaide, South Australia, for confirmation of the diagnosis of carbohydrate malabsorption were analysed with the Quintron microlyzer (Quintron Instrument Co., Milwaukee, USA) and the BreatH2 analyser, using the Quintron microlyzer as the gold standard. Results: Twenty-nine breath H2 tests (BHT) were performed in 29 patients aged 2 months to 61 years. The sensitivity and specificity of the BreatH2 analyser in detecting a positive BHT using the Quintron microlyser as the gold standard were 0.90 and 0.95 with positive and negative predictive values of 0.90 and 0.95, respectively. There was one false positive and one false negative reading. Bland,Altman plots showed a high degree of agreement between the values obtained with two different methods. Conclusions: The diagnosis of carbohydrate malabsorption, using a portable breath H2 analyser (BreatH2), achieved an acceptable degree of sensitivity and specificity, enabling it to be used where no alternative is available. [source] | ||||||||||