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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To test the hypothesis that subclinical enteric infection (such as bacterial overgrowth), rice malabsorption, and growth faltering are causally linked, a field trial of low-dose, short-term, intermittent antibiotic treatment was carried out in 142 hydrogen-producing (by lactulose breath hydrogen test) Burmese village children aged 6-59 months. The children were randomly allocated treatment with metronidazole (20 mg/kg or 5 mg/kg daily), amoxycillin (25 mg/kg daily), or placebo given 1 week per month for 6 months. A cooked rice meal breath hydrogen test was done to classify the children as rice absorbers (RA) or rice malabsorbers (RM) before treatment and monthly on the day before each cycle of treatment. There were no differences between the treatment groups, so they were considered together. Factorial analysis showed that antibiotic treatment did not significantly affect the proportion of RM children. The only significant difference between antibiotic-treated and placebo-treated children's growth was in the subgroup of RM children aged 36-47 months; the antibiotic-treated children had significantly greater linear growth. In other age groups antibiotic treatment had no effect on growth.
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PMID:Effect of short-term intermittent antibiotic treatment on growth of Burmese (Myanmar) village children. 197 80

Ninety infants and young children with acute gastroenteritis were investigated for lactose malabsorption. Each of them was given an oral lactose load of 2g per kg of body weight after which breath hydrogen excretion was measured, and each was observed for clinical symptoms of lactose intolerance. Only 2 patients, given 2g per kg of lactose, had clinical lactose intolerance. Forty-nine of the 90 patients studied were found to have the rotavirus antigen in their stools. Forty-five of them were found to have an abnormal lactose breath hydrogen test (LBHT). Twenty-three patients with abnormal LBHT were restarted on a diluted lactose-containing formula for oral feeding. They required longer hospitalization (mean 6.7 days, range 3-14 days) and were free of diarrhea in 14 days (mean 7.5 days). Twenty-two patients found to have an abnormal LBHT were given a nonlactose-containing formula (Isomil, Nursoy, Alsoy, ProSobee, or Bebelac FL) when restarted on oral feeding. All patients require less than 5 days of hospitalization and free of diarrhea in 5 days (mean 3.4 days). The difference was statistically significant (p less than 0.05).
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PMID:Breath hydrogen test for assessment of lactose malabsorption following rotavirus gastroenteritis. 198 76

Because gastrointestinal dysfunction is a major problem in children with human immunodeficiency virus (HIV) infection, we utilized breath hydrogen measurements to determine the relationship between disaccharide malabsorption and gastrointestinal dysfunction in HIV-infected children. We found a strong association between lactose intolerance and persistent diarrheal disease in this population (p less than 0.007, Mann-Whitney U test). We also found evidence of sucrose malabsorption and persistent diarrheal disease in three of the children. Extensive microbiologic evaluations failed to reveal an etiologic agent related to the occurrence of gastrointestinal symptoms. Our findings indicate that disaccharide intolerance is a common occurrence in HIV-infected children with persistent diarrheal disease. Careful attention to dietary intake may be required to ameliorate clinical symptoms and to maintain adequate nutrition.
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PMID:Gastrointestinal dysfunction and disaccharide intolerance in children infected with human immunodeficiency virus. 199 74

The prevalence of lactose maldigestion in Greek adults is 75% but the age at which the lactase activity starts declining is not known. The prevalences of lactose maldigestion and intolerance were investigated in 150 randomly selected Greek children 5-12 y old by using breath-hydrogen analysis after ingestion of lactose (2 g/kg body wt, maximum 50 g) or 0.240 L of milk. Prevalence of lactose maldigestion increased with age (y = -7.30 + 6.49x, r = 0.88, P = 0.004), being 29.4% and 80.0% at ages 5 and 12 y, respectively. Before testing, the reported prevalences of milk-related symptoms by children with high and low lactose-digestion capacity were 21.1% and 39.7% (chi 2 = 5.96, P = 0.015), respectively. However, the corresponding prevalences of lactose intolerance after ingestion of milk were 7.3% and 8.6% (chi 2 = 0.1, P = 0.72) and only three children had a delta H2 greater than or equal to 20 ppm postprandially. Although intestinal lactase activity declines before age 5 y and many Greek children report milk-related symptoms, true malabsorption and intolerance of lactose after a glass of milk is rarely seen at this age.
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PMID:Lactose maldigestion and milk intolerance in healthy Greek schoolchildren. 200 Aug 21

The nutritional needs of children with human immunodeficiency virus infection are poorly understood. Twenty-eight children with vertically transmitted human immunodeficiency virus infection were evaluated for carbohydrate malabsorption using lactose hydrogen breath tests and d-xylose absorption studies. Lactose malabsorption was a common finding in human immunodeficiency virus-infected children and occurred in 8 of 20 patients who had no identifiable enteric pathogen. Lactose malabsorption occurred at an earlier age in human immunodeficiency virus-infected children than in an age-matched group of 45 symptomatic control children (P = 0.02). However, lactose malabsorption was not associated with higher rates of diarrhea or growth failure. Abnormalities in d-xylose absorption were not significantly associated with either diarrhea or growth failure. However, 39% of d-xylose studies (9 of 23) showed abnormal results and were significantly associated with enteric infections (P = 0.004). Abnormalities in small-bowel morphology were found in 4 of 9 children with growth failure, 3 of whom had an enteric infection and low d-xylose absorption. Lactose hydrogen breath testing and d-xylose testing showed carbohydrate malabsorption in 61% of children (17 of 28). This study demonstrates that human immunodeficiency virus-infected children are at risk for malabsorptive disorders, which are not always related to clinical symptoms. We speculate that human immunodeficiency virus may be directly involved in the development of lactose malabsorption. Carbohydrate malabsorption in human immunodeficiency virus-infected children may not be the only factor responsible for growth failure.
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PMID:Malnutrition and carbohydrate malabsorption in children with vertically transmitted human immunodeficiency virus 1 infection. 201 74

Although starch provides a large fraction of human caloric intake, there is limited information concerning the efficiency of intestinal absorption of this nutrient. Owing to the fermentation of starch by colonic bacteria, there is no quantitative test for starch absorption comparable to the fecal fat determination. The most accurate estimation of starch absorption has been obtained by intubating the terminal ileum and aspirating ileal contents following ingestion of a meal containing starch plus a nonabsorbable marker. Starch absorption is calculated from the ratio of starch:marker in the ileal aspirate relative to the ratio in the meal. Disadvantages of the technique are the requirement for ileal intubation and the possible adverse effect of intubation on the absorptive process. A more widely used technique to assess starch absorption involves measurement of breath hydrogen (H2) excretion after ingestion of starch. Malabsorbed starch is fermented by colonic bacteria with liberation of H2 that is absorbed and excreted in expired air. This test is simple and noninvasive and can provide quantitative measurements of starch malabsorption. Application of this technique has demonstrated that 5-10% of starch in wheat, potatoes, and corn is not absorbed by healthy subjects, while rice starch is nearly completely absorbed.
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PMID:Measurement of starch absorption in humans. 203 92

Breath hydrogen (H2) measurements are applied in clinical medicine for the detection of carbohydrate malabsorption. H2 in expired air results when dietary sugars escape absorption in the small intestine, thereby becoming available for bacterial fermentation. H2 produced by bacterial metabolism of the carbohydrate is absorbed into the portal circulation and excreted in breath. Relatively simple collection, storage, and analysis methodologies have been developed in recent years. They permit convenient and noninvasive testing of patients in most age groups for common clinical disorders of digestion and absorption, including lactase deficiency and other disorders of di- and mono-saccharide malabsorption, starch malabsorption, and small bowel bacterial overgrowth. Limitations of breath hydrogen testing are few. Developmental considerations constrain the ease of interpretation of breath H2 measurements in early infancy, and factors affecting intraluminal H2 production by the intestinal flora may occasionally affect the H2 signal. Despite these factors, breath H2 testing has repeatedly been demonstrated to be the most accurate indirect indicator of lactase deficiency, and breath H2 measurements have been widely applied in studying digestion of the entire spectrum of dietary carbohydrates.
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PMID:Clinical application of breath hydrogen measurements. 203 93

It has been suggested that a significant amount of starch may reach the colon undigested and stimulate microbial fermentation. Indirect estimates of the quantity of starch reaching the colon have been obtained from breath hydrogen (H2) measurements, but numerous variables, i.e., dietary fiber source and level of intake, oral hygiene, hyperventilation, and cigarette smoking, stimulate H2 production and may exaggerate estimates of starch malabsorption. With proper controls, however, the lactulose breath H2 test based on total excess volume seems to provide a reasonable measure of the average amount of starch metabolized in the colon. Direct estimates of starch metabolism from human ileostomy studies suggest that typically less than 5% of the ingested starch escapes digestion in the small intestine. The general assumption that starch malabsorption stimulates normal colonic function, particularly with respect to colorectal carcinogenesis, is not entirely supported by the limited number of available epidemiologic studies. Further experimental studies are needed to elucidate the role of starch intake and malabsorption on colonic function and human health issues.
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PMID:Passage of starch into the colon of humans: quantitation and implications. 203 95

The relative effectiveness of five milk products with various levels of lactose reduction [0%, 50%, 80% (#1), 80% (#2), and 95%] was evaluated in six subjects with lactose malabsorption. Breath hydrogen was measured for 4 h after consumption of 300 mL of each product in a single-blind, randomized design. The mean +/- SEM maximum breath-hydrogen rise (ppm) after the 0%, 50%, 80% (#1), 80% (#2), and 95% lactose-reduced (LR) milks was 31 +/- 6, 7 +/- 3, 5 +/- 3, 5 +/- 2, and 8 +/- 3, respectively. The difference between whole milk and the LR milks was statistically significant (P less than 0.05) but there was no difference between any of the LR milks. Whole milk provoked symptoms in most subjects whereas 95% LR milk produced none. Only one of six subjects reacted to the 50% and 80% LR milks. The results suggest that a 50% level of lactose reduction in milk may be adequate to relieve the signs and symptoms of milk intolerance in the majority of healthy adults with lactose malabsorption.
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PMID:Relative effectiveness of milks with reduced amounts of lactose in alleviating milk intolerance. 205 76

We measured breath hydrogen excretion in 103 neonates from birth to as late as 2 months of age. The patients weighed less than 2000 g at birth and were part of a study of hydrogen excretion as a screening test for necrotizing enterocolitis. Hydrogen excretion in parts per million was normalized for the quality of the expired air by dividing by the Pco2 of the gas sample The rise in the H2/CO2 ratio was influenced by gestational age, energy intake, and antibiotic usage but not by the daily frequency of feeding. The mean +/- SD peak H2/CO2 ratio was 5.1 +/- 3.6 ppm per millimeter of mercury and occurred at 16.0 +/- 11.0 days of age. The age at which the peak H2/CO2 occurred varied with gestational age. Patients born between 23 and 28 weeks gestational age (n = 34) were 22.9 +/- 13.1 days of age when they experienced their peak H2/CO2 ratio, whereas those born between 29 and 34 weeks gestational age (n = 62) were 12.2 +/- 7.5 days of age. The age at which the peak H2/CO2 ratio occurred did not differ between these two groups when corrected for the age at which oral intake exceeded 420 kJ/kg per day. These results suggest that premature neonates require experience with ingesting more than 420 kJ/kg per day before bacteria and carbohydrates are present in large enough quantities to permit measurable hydrogen production. This information will be useful in future studies of premature gut development and physiology and in studying pathologic processes in which malabsorption may play a role.
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PMID:Breath hydrogen excretion in the premature neonate. 210 30


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