Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000729 (abdominal cramps)
 531 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the dry season in the rural village of Keneba, The Gambia, health workers conducted the lactose breath hydrogen test on 218 children, 13-72 months old, following an overnight fast and ingestion of an aqueous factors solution (2 gm/kg body weight). They also took anthropometric measurements and a 2-week clinical history to determine the age-related prevalence of lactose maldigestion (LM) and to link it to diet, growth, and clinical signs and symptoms of lactose intolerance. Overall LM prevalence stood at 68% . 3-5 year old children were significantly more likely to have LM than 2-year-olds (76% vs. 21%; p .001), coinciding with weaning. Lactose digesters and lactose maldigesters began supplementary feeds and were completely weaned at essentially the same age. Yet, a greater proportion of lactose digesters still consumed breast milk (85% vs. 15%), while a greater proportion of lactose maldigesters were completely weaned (63% vs. 37%) (p .001). LM did not affect weight-for-age or weight-for-height, suggesting that LM does not contribute to childhood growth failure. 8 children suffered from diarrhea during the 2 weeks before the test. 7 children had clinical signs of lactose intolerance (flatus, diarrhea, and/or abdominal cramps). These results led the researchers to recommend that cow's milk should only be given to completely weaned children as a means to supplement carbohydrate, protein, and calcium in areas with high rates of protein energy malnutrition.
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PMID:Is cow's milk suitable for the dietary supplementation of rural Gambian children? 1. Prevalence of lactose maldigestion. 128 64

Reduced intestinal absorption of levothyroxine (LT4) is the most common cause of failure to achieve an adequate therapeutic target in hypothyroid patients under replacement therapy. We present the case of a 63-year-old woman with autoimmune hypothyroidism previously well-replaced with tablet LT4 who became unexpectedly no more euthyroid. At presentation, the patient reported the onset of acute gastrointestinal symptoms characterized by nausea, loss of appetite, flatulence, abdominal cramps and diarrhea, associated with increase of thyrotropin levels (TSH: 11 mIU/mL). Suspecting a malabsorption disease, a thyroxine solid-to-liquid formulation switch, at the same daily dose, was adopted to reach an optimal therapeutic target despite the gastrointestinal symptoms persistence. Oral LT4 solution normalized thyroid hormones. Further investigations diagnosed giardiasis, and antibiotic therapy was prescribed. This case report is compatible with a malabsorption syndrome caused by an intestinal parasite (Giardia lamblia). The reduced absorption of levothyroxine was resolved by LT4 oral solution. Learning points: The failure to adequately control hypothyroidism with oral levothyroxine is a common clinical problem. Before increasing levothyroxine dose in a patient with hypothyroidism previously well-controlled with LT4 tablets but no more in appropriate therapeutic target, we suggest to investigate non adhesion to LT4 therapy, drug or food interference with levothyroxine absorption, intestinal infection, inflammatory intestinal disease, celiac disease, lactose intolerance, short bowel syndrome after intestinal or bariatric surgery, hepatic cirrhosis and congestive heart failure. LT4 oral solution has a better absorptive profile than the tablet. In hypothyroid patients affected by malabsorption syndrome, switch of replacement therapy from tablet to liquid LT4 should be tested before increasing the dose of LT4.
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PMID:Switch from tablet levothyroxine to oral solution resolved reduced absorption by intestinal parasitosis. 3089 50