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PubMed2001

Intolerance to lactose and other dietary sugars.

Intolerance of dietary carbohydrate and sugars can result from a variety of genetically determined enzyme and transporter deficiencies. This article reviews this topic and discusses in more detail the current state of our own research on lactase.

Carbohydrates↗
PubMed2003

Applicability of short hydrogen breath test for screening of lactose malabsorption.

The gold standard for diagnosing lactose malabsorption is the H2 hydrogen breath test (HBT). Different methods of HBT have been proposed. However, in clinical practice the HBT is often shortened to 1-2 hr without proper validation. Our objective was to establish whether the usefulness of the HBT is influenced by shortening of the test and/or by substrate variations. In 62 patients with clinically suspected lactose intolerance and a positive lactose HBT we calculated the sensitivity of the HBT depending on the duration of the HBT. To determine whether substrate variations influence the sensitivity of the HBT, in another group of 32 patients with clinically suspected lactose intolerance and a positive milk HBT, the sensitivity of the HBT was also calculated depending on the duration of the test after milk ingestion. In other unselected 97 individuals, the result of the HBT with 360 ml of whole milk supplemented with lactose was compared with a symptomatic score for lactose intolerance to evaluate the specificity of the shortened milk HBT. Breath H2 excretion was significantly higher after lactose than after milk load (P < 0.01), and the increase in H2 appeared earlier with lactose than with milk (60 vs 90, min respectively). HBT duration influenced the sensitivity of the test that decreased from 95% for the 3-hr HBT to 37% for the 1-hr HBT with lactose and from 80% for 3-hr HBT to 21% for 1-hr HBT with milk. The specificity was similar for the 3-hr milk HBT and the 5-hr test (67 vs 62%). In conclusion, for screening of lactose malabsorption, the HBT can be shortened to 3 hr without loss of sensitivity and specificity, when a high dose of lactose load is used.

Adult↗
PubMed1985

Tolerance to glucose polymers in malnourished infants with diarrhea and disaccharide intolerance.

The response of infants with diarrhea and lactose intolerance to feedings containing soy protein and sucrose (Sobee), and/or to a carbohydrate free formula (RCF), to which glucose polymers (GP) were added, was assessed in twenty patients. They all were less than ten months of age and had varying degrees of malnutrition. Eleven had acute diarrhea and nine had chronic diarrhea. None of them had classical enteropathogenic strains and parasites in the stools. All had lactose intolerance when feedings were begun with cow's milk formula and some also had sucrose intolerance when fed sucrose containing soy formulas. They had persistent loose stools and excreted feces with an acid pH and with carbohydrates, thus they were given dietary treatment with RCF with GP. There were 9 patients with acute diarrhea and lactose intolerance (1 of them also had sucrose intolerance), who improved on RCF with GP feedings; but 2 patients (lactose and sucrose intolerant) failed to respond to this diet. There were six patients with chronic diarrhea and lactose intolerance (four of them also had sucrose intolerance), who improved on RCF with GP formula, but there were three patients who failed on this treatment. These data show that some infants with diarrhea, malnutrition, and lactose-sucrose intolerance may also develop intolerance to GP and require further dietary management with glucose as the source of carbohydrate in the diet.

Acute Disease↗
PubMed1968

Sugar intolerance in malnourished infants and children.

Of 100 malnourished Indian infants and children 50 showed a stool pH below 6. Carbohydrate-loading tests demonstrated intolerance to lactose in 39, to sucrose in 25, and to maltose in 15. D-Xylose absorption was reduced in 16. Steatorrhoea was detected in 7 of 18 children tested. Nutritional recovery reversed the abnormalities in all except four, in whom a primary enzymic deficiency was considered on the basis of persistent lactose intolerance and a positive family history.

Carbohydrates↗
PubMedDate not supplied

Use of chestnut in the feeding of infants allergic to cow's milk or intolerant to lactose.

The aminoacid contents of native chestnut and its powdered form were studied. It was found that it has low cystine and methionine contents but if it is supplemented accordingly, the chestnut pulp can well be used for infant feeding. More than 50 infants were fed with chestnuts, and only in two cases was there intolerance. The aminoacid content of supplemented chestnut formula was lower than that of cow's milk and soy bean, but equal to that of human milk and as its essential aminoacid ratio was high, the infant's development was normal. Chestnut pulp is recommended as an alternative to soybean in the treatment of lactose intolerance and cow's milk allergy.

Amino Acids↗
PubMed1998

[Bone changes in gastrointestinal diseases].

BACKGROUND: Gastrointestinal (GIT) diseases are a common cause of metabolic bone changes. The aim of the study was to indicate GIT diseases (lactose intolerance, non-lactose intolerance, Crohn's disease, ulcerative colitis, pancreatic insufficiency, states after gastric resection, chronic diseases of the liver, and coeliac disease) by means of literature data and the authors' own results coinciding with the detected low bone density and thus increased risk of fracture. Bone changes coinciding with GIT diseases are frequent and are commonly asymptomatic for a long period. CONCLUSION: In coincidence with GIT diseases the authors indicate the necessity of being aware of the risk of bone changes development and to investigate them actively. An early diagnosis aids to introduce preventive and therapeutical measures and to halt or at least slow down the origin of bone changes. (Ref. 21.)

Bone Diseases, Metabolic↗
PubMedDate not supplied

[Utility of studying feces for the diagnosis and management of infants and preschool children with acute diarrhea].

OBJECTIVE: To analyze the results of a stool work-up protocol in a series of infants and preschoolers with acute diarrhea. MATERIAL AND METHODS: A cross-sectional descriptive study was conducted between April 1999 and March 2000, among 288 children seen at a pediatric office in Guadalajara, Mexico. The mean age (+/-/SD) was 23.1 +/- 13.9 months; 43% were females. Data were collected on demographic and clinical characteristics. The stool work-up consisted of fresh smear and methylene blue and Kinyoun smears, as well as determination of pH and reducing substances. Stool culture was performed in samples with > or = 3 leukocytes/microscopic field and rotavirus antigen detection only in selected cases. Data were analyzed using descriptive statistics, chi 2, odds ratios, and 95% confidence intervals. RESULTS: Enterophatogens (%) identified were: rotavirus 47.1, Campylobacter jejuni 27.4, Salmonella spp. 5.1, Shigella spp. 4.3, Cryptosporidium parvum 2.8, Giardia lamblia 2.4, Blastocystis hominis 1.4, Entamoeba histolytica 0.7. An OR of 5.7 was obtained for isolation of enteroinvasive bacteria in the presence of fecal leukocytes. Lactose intolerance was detected in 19.1%. The frequencies of rotavirus antigen identification and lactose intolerance were significantly higher in infants; the OR for lactose intolerance in infants with rotavirus was 21. Mucus and blood in the stools were associated to enteroinvasive bacteria and Cryptosporidium parvum. CONCLUSIONS: The current stool work-up protocol allowed the identification of enteropathogenic parasites, rotavirus and lactose intolerance in a short period of time. Leukocytes in stools were associated to the isolation of enteroinvasive bacteria. The frequency of agents associated to diarrheal disease was similar to that from other national studies. This stool work-up protocol could be useful as a tool to limit the unnecessary prescription of drugs and to follow universal recommendations for dietary management of these patients. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Acute Disease↗
PubMed1988

Relationship between milk lactose tolerance and body mass in teenage Tswana schoolchildren.

The Tswana and other black races of southern Africa have a high prevalence of the adult type of primary lactose intolerance. It is possible that nutritional status may affect lactose absorption, so that lactose malabsorbers may be less well nourished than lactose absorbers. However, such a poor nutritional status may have caused, or have been caused by, the lactose malabsorption. It is also possible that another factor, such as chronic diarrhoea, may cause both poor nutrition and lactose intolerance. A random sample of 92 Tswana pupils was taken from a school population of 486. Their heights and weights were measured, and the relative weight and body mass index (weight/height2) calculated for each subject. A milk tolerance test was administered to each subject to establish whether they were lactose tolerant or intolerant. There were 79 (85.9%) lactose intolerant subjects, 7 (7.6%) were probably intolerant and only 6 (6.5%) were lactose tolerant. The nutritional status of the lactose intolerant and tolerant subjects were compared. The two groups did not differ in nutritional status, as measured by their relative weights and body mass indices, and were nutritionally similar to a reference population of Tswana schoolchildren.

Adolescent↗