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

We analyzed the results of 352 consecutive four-hour lactose hydrogen breath tests with the aim of verifying whether the results after two hours have the same accuracy as those after four hours in the diagnosis of malabsorption of 20g of lactose. Our results show that in 208 subjects who proved to be lactose malabsorbers the mean changes in breath H2 concentration were higher at three and a half hours than at any other time. Moreover, although the majority of the subjects (63%) reached the cut-off value (more than 20 parts per million with respect to the baseline value) in the first two hours of the test, in 76 of our 208 lactose malabsorbers (37%) a hydrogen increase higher than the cut-off value is only detectable after the second hour of the test. Therefore, unlike those who believe that two samples of expired air at 0 time and after two hours are sufficient, we think that for greater diagnostic accuracy the lactose H2 breath test must be prolonged for at least 4 hours.
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PMID:Methodology of the H2 breath test. II. Importance of the test duration in the diagnosis of carbohydrate malabsorption. 213 33

Breath-hydrogen tests (BHTs) were performed on 310 Burmese village children aged 1-59 mo. After a 10-g lactulose test meal, 94 (30.3%) children produced less than 10 ppm H2 above basal values (nonhydrogen producers). Of 216 hydrogen producers, 210 were tested after a cooked rice meal (3 g cooked rice/kg body wt, equivalent to 1 g carbohydrate/kg body wt) with the BHT. Hydrogen peaks greater than or equal to 10 ppm above baseline concentrations were produced by 133 (66.5%) children who were defined as rice malabsorbers. Forty-three percent to 62% of children were less than or equal to -3 SD of the National Center of Health Statistics (NCHS) median weight-for-age and length-for-age and less than -2 SD of the NCHS median weight-for-length. There were no differences between rice absorbers (peak hydrogen less than 10 ppm above baseline) and rice malabsorbers in the allometric indices (the Ehrenberg index and the Dugdale index) of weight-for-length. Rice-carbohydrate malabsorption was also detected by BHTs in 26.7% of 86 school children (aged 5-15 y), 38.5% of 39 young adults (aged 15-39 y), and 50% of 34 older adults (aged 40-70 y).
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PMID:Absorption of carbohydrate from rice in Burmese village children and adults. 214 51

Breath-hydrogen tests were performed after a rice meal (3 g cooked rice/kg body wt, equivalent to 1 g carbohydrate/kg body wt) at monthly intervals for 6 mo on 75 village children aged 1-59 mo who were known hydrogen producers. The overall rate for rice-carbohydrate malabsorption was 46.7% (range 37.3-56.0%). Anthropometric measurements were made every 3 mo and growth rates were calculated. Forty-six percent to 59% of children were less than or equal to -3 SD of the National Center for Health Statistics (NCHS) median weight-for-age and length-for-age and less than -2 SD of the NCHS median weight-for-length. Rice malabsorbers (ie, those with hydrogen peaks greater than or equal to 10 ppm above baseline concentrations) in the age groups 36-47 mo and 48-59 mo had statistically significant diminished growth expressed as percent gain in length per annum per child (p less than 0.02). Thus, rice malabsorbers had a deficit in linear growth of 2.7 cm/y (range 2.5-2.9 cm/y) for children aged 36-47 mo old and 1.9 cm/y (range 1.7-2.1 cm/y) for children aged 48-59 mo.
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PMID:Malabsorption of carbohydrate from rice and child growth: a longitudinal study with the breath-hydrogen test in Burmese village children. 214 52

The influence of pasta cooking time on starch digestion and plasma glucose and insulin responses was studied in 12 healthy subjects. During 3 consecutive days, one of three pasta test meals (50 g starch) cooked for 11, 16.5, and 22 min was served to each volunteer in a random order. Hydrogen and methane breath excretion was measured after pasta ingestion; plasma responses were compared with those of an equivalent oral glucose-tolerance test. No significant differences were found between cooking times and plasma indices, orocecal transit time, or incremental hydrogen excretion (delta peak hydrogen). With one exception, pasta meals that were completely absorbed were ingested by methane producers. Postprandial delta peak hydrogen was significantly lower in methane than in nonmethane producers (p less than 0.02). These results point to a lack of influence of cooking time on nutritional characteristics of pasta and suggest that starch malabsorption determined by breath-hydrogen-test criteria may be underestimated in methane producers.
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PMID:Pasta cooking time: influence on starch digestion and plasma glucose and insulin responses in healthy subjects. 217 90

The upper small intestine is usually "sterile" in a healthy individuals, but due to some reasons the number of microorganisms may reach or increase above 10(4)/ml, leading to the contamination of the small intestine, which may cause severe malabsorption. The authors have diagnosed this syndrome in 50 children, aged between 1 month and 3 years, using breath hydrogen test and duodenal juice culture. Most of these children had growth retardation. According to their experience the authors found that the oral antibiotic is the effective treatment of this syndrome.
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PMID:[Contaminated small bowel syndrome in infants caused by gram-negative bacteria and yeasts]. 220 23

The Authors examined 515 children with abdominal pain in the outpatient clinics for a period of two years. The pain was frequently periumbilical or mid epigastric with a history of more than two months. Persistent lactose malabsorption was found in 252 children (48,9%), which justifies the use of Breath Hydrogen Test as a first diagnostic procedure for assessing recurrent abdominal pain. Putative pathogens were identified in the stool specimens of 21 patients. Oesophagitis was diagnosed in 18 children and duodenal ulcer in one. 91 patients (less than 6 years old) improved after successful treatment of the chronic upper respiratory inflammations. The authors did not find any causes in 18.1 per cent of the children examined and they think that the abdominal pain in these children may be psychogenic. The use of high-fiber diet is proposed for the later group.
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PMID:[Chronic recurrent abdominal pain and lactose malabsorption in childhood]. 226 51

This double-blind study was performed to evaluate the relation of the glycemic and hormonal (insulin, gastric inhibitory polypeptide) responses to standardized starch and sucrose meals to signs (H2 exhalation) and subjective symptoms of carbohydrate malabsorption during administration of 100 mg BAYm 1099 (miglitol) t.i.d. over a period of 8 weeks. Two groups of 8 male healthy volunteers received either placebo or verum. Oral sucrose loading tests (50 g) with and without miglitol were performed at day -5, 1, 25 and 53 of the study, starch loading tests (50 g) with and without the inhibitor were carried out at day -2, 4, 28 and 56. Miglitol significantly flattened the glycemic responses to sucrose and starch without evidence of diminished efficacy over the 8-week period. Also the blunting effect of miglitol on serum insulin and gastric inhibitory polypeptide responses and the stimulation of breath hydrogen exhalation proving carbohydrate malabsorption with starch and sucrose remained unchanged over time. Comparing breath hydrogen exhalation, responses were more pronounced after sucrose than after the starch loading tests. Symptoms (bloating, flatulence, diarrhea, cramps) were merely noticeable with starch as the substrate, but clearly present after sucrose. These symptoms were substantially curtailed during continuous drug intake. It is concluded that - irrespective of the substrate (starch/sucrose) - there is no escape of the desired effects of alpha-glucosidase inhibition by miglitol over 8 weeks, but symptoms of gaseousness due to carbohydrate malabsorption may undergo habituation.
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PMID:Postprandial glycemic control, hormonal effects and carbohydrate malabsorption during long-term administration of the alpha-glucosidase inhibitor miglitol. 229 49

As part of a study to assess the possible contribution of lymphoid infiltration of the gastrointestinal mucosa to occult blood loss or malabsorption 20 patients with chronic lymphocytic leukaemia (CLL) had a lactulose hydrogen breath test. In 10 cases (50%) a small intestinal peak was detected, suggesting small bowel bacterial overgrowth, and this was confirmed in seven patients by the positive culture of jejunal aspirate. Of the patients with a positive hydrogen breath test, radiological examination showed a duodenal diverticulum in two but no anatomical abnormalities in the other cases. There was no evidence of achlorhydria and transit times were normal. There was no difference in the incidence of hypogammaglobulinaemia among those patients with evidence of small intestinal bacterial overgrowth and those without. Seven patients with a positive hydrogen breath test, however, had undetectable secretory piece in their jejunal aspirates whereas this was present in all patients with a normal breath test who had local immunoglobulin concentrations measured (p less than 0.05), indicating that the small intestinal bacterial overgrowth may be due to impaired local immunity.
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PMID:Small intestinal bacterial overgrowth in patients with chronic lymphocytic leukaemia. 231 52

Because even after low doses of fructose and sorbitol, fructose-sorbitol malabsorption has been found in a high number of patients with the irritable bowel syndrome, an etiological role of fructose-sorbitol malabsorption in the irritable bowel syndrome has been suggested. However, these studies have been uncontrolled. Therefore, a controlled study of fructose-sorbitol malabsorption in the irritable bowel syndrome compared with healthy controls was performed. Seventy-three patients, 23 men and 50 women with a mean age 43.1 +/- 1.7 years (range, 18-66 years) with the irritable bowel syndrome were compared with 87 age- and sex-matched control subjects. Fructose-sorbitol malabsorption was determined by a breath-hydrogen test (Lactoscreen, Hoek Loos, Schiedam, The Netherlands) following an oral load of 25 g fructose and 5 g sorbitol after a 10-hour fast. Fructose-sorbitol malabsorption, as shown by an H2 peak of 20 ppm over basal values, was found in 22 (30.1%) of the patients and 35 (40.2%) of the control subjects. With a lower peak level of 10 ppm over basal values, these percentages were 45.2% and 57.5%, respectively. Also, the highest H2 peak values (15.2 +/- 2.3 ppm vs. 21.5 +/- 2.6 ppm), time to reach peak levels (110.7 +/- 5.4 min vs. 107.1 +/- 5.9 min), and area under the H2 curve (1310 +/- 219 ppm.min vs. 1812 +/- 255 ppm.min) did not discriminate between patients and controls. During the test, symptoms developed in 31 of 70 patients and in 3 of 85 control subjects (P less than 0.0001). Symptomatic patients did not differ from asymptomatic patients regarding the presence or absence of fructose-sorbitol malabsorption, H2 peak values, and area under the curve. No differences could be identified between male and female patients or controls. In conclusion, fructose-sorbitol malabsorption is frequently seen in patients with irritable bowel syndrome, but this is not different from observations in healthy volunteers. Therefore, fructose-sorbitol malabsorption does not seem to play an important role in the etiology of irritable bowel syndrome.
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PMID:Role of fructose-sorbitol malabsorption in the irritable bowel syndrome. 193 20

Adult (primary) lactose malabsorption is practically universal in Africans of Bantu and San ('Bushmen') stock. Recent environmental changes, especially in rural areas, have exacerbated rates of malnutrition in hospital patients belonging to these groups. In order to assess the advisability of using milk as a nutritional supplement for such patients, the tolerance and absorption of 350 ml boluses of whole milk (containing 17 g lactose) was measured in 110 malnourished hospitalized patients in Namibia and South Africa belonging to Bantu (ie, Zulus, Hereros, and Kavangos) and San (ie, Bushmen) populations and compared with 22 healthy Westernized controls. Mild symptoms of intolerance were noted in about 10 per cent of Bantus and 20 per cent of Bushmen in comparison to 33 per cent of lactose-malabsorbing controls consuming Westernized diets and reported rates of 48 and 80 per cent in American population studies. The average increase in breath hydrogen excretion of 20 parts per million was also lower than the value of 34 parts per million in controls. Fasting breath methane concentrations were high in between 60-84 per cent of the groups of patients, but the level was not significantly affected by milk ingestion. Despite the combination of hypolactasia and malnutrition, 350 ml drinks of milk were well tolerated by African patients. Thus, milk should form an appropriate nutritional supplement for Africans hospitalized in rural areas.
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PMID:Milk tolerance and the malnourished African. 240 Dec 80


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