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

It is a common clinical practice to initiate enteral hyperalimentation using low flow rates or diluted formula. These adjustments are made in an effort to minimize patient intolerance. Using complex and elemental enteral formulas, we investigated whether various flow rates or osmolalities effected clinical intolerance or carbohydrate malabsorption in 20 healthy volunteers. Our infusion rates ranged between 50 and 150 kcal/hr and the osmolalities ranged between 325 and 690 mOsm/Kg of water. Even at the maximal flow rate and osmolality, our results show that both types of enteral formulas were well tolerated as assessed by the frequency of abdominal pain, bloating, passage of rectal gas and stooling. No carbohydrate malabsorption was detected as measured by breath hydrogen. In well nourished subjects, our findings do not support the common clinical practice of initiating alimentation with low flow rates or diluted formula.
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PMID:Effect of enteral formula infusion rate, osmolality, and chemical composition upon clinical tolerance and carbohydrate absorption in normal subjects. 309 2

Enhanced digestion of yogurt by lactose-intolerant individuals is believed to be due to inherent beta-galactosidase (lactase) in the culture organisms that aids in the hydrolysis of ingested lactose. However, sweet acidophilus milk, which contains lactase-rich organisms, does not enhance lactose digestion. Using breath-hydrogen measurements to indicate malabsorption in 14 human subjects, we compared utilization of: milk, yogurt, heated yogurt, yogurt plus lactose, heated yogurt plus lactase, sweet acidophilus milk (SAM), and SAM made with sonicated cells. Results indicate that both the reduction of lactose during fermentation and the presence of indigenous bacterial lactase are responsible for the increased ability to tolerate lactose in yogurt. Improved utilization of SAM by sonication suggests that intracellular lactase is not available during digestion and that sonication releases the lactase activity from the cells.
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PMID:Modification of sweet acidophilus milk to improve utilization by lactose-intolerant persons. 310 15

The effects of oral enzyme replacement therapy on breath hydrogen excretion and symptoms after milk ingestion were studied in lactase-deficient patients. Sixteen symptomatic patients underwent interval hydrogen breath tests using whole milk as substrate. Each study was repeated with the addition of 250 mg of beta-D-galactosidase derived from Aspergillus oryzae (Lactrase) given orally with the milk. Subsequently seven of those 11 patients who did not normalize their hydrogen excretion with 250 mg of Lactrase were available to be restudied with a 500-mg dose. Mean cumulative and peak hydrogen excretions were calculated for the baseline (milk alone), 250 mg, and 500 mg Lactrase groups. Significant (p less than or equal to 0.05) decreases in cumulative and peak hydrogen excretion were noted between the 500 mg Lactrase versus the baseline group, but not between the 250 mg versus baseline group. Five of the 16 (31%) symptomatic lactase-deficient patients normalized their hydrogen excretion after 250 mg of Lactrase; four of seven (57%) who had not normalized on 250 mg, normalized their hydrogen excretion with 500 mg of Lactrase. A different pattern was observed in the incidence of symptoms. Five of the nine patients (56%) whose hydrogen excretion normalized with the addition of Lactrase at either dosage became asymptomatic after milk ingestion; in addition, three patients who did not normalize their hydrogen also became asymptomatic. We conclude that oral Lactrase in sufficient dosage temporarily reverses lactose malabsorption in some patients.
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PMID:Does oral enzyme replacement therapy reverse intestinal lactose malabsorption? 311 Dec 43

Lactose malabsorption was studied by a breath hydrogen technique in 139 Samoan and 68 white schoolchildren. The Samoans were studied in four locations, two in Western Samoa and two in New Zealand, and the white children in both the Cook Islands and New Zealand. The prevalence of malabsorption varied with location: for Samoans it ranged from 41% to 60% in Western Samoa and 0% to 35% in New Zealand; white children had rates of 27% in the Cook Islands and 5% in New Zealand. Environmental factors rather than genetic factors are likely to play the main part in initiating if not perpetuating lactose malabsorption. In both races lactose malabsorption had no effect on the acceptance of, consumption of, and number of gastrointestinal symptoms caused by milk and milk biscuits. Children who had symptoms after consuming a particular dairy product were more likely to say they disliked it than those who reported no symptoms.
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PMID:Lactose malabsorption in Polynesian and white children in the south west Pacific studied by breath hydrogen technique. 311 83

A total of 852 healthy Chinese children from 1 month to 14 years of age were investigated for lactose malabsorption using the breath hydrogen test. A lactose load of 2 g/kg was administered to 528 children and 1 g/kg to another 324 children. The incidence of lactose malabsorption was significantly different among various age groups and between the two different lactose dosages. While the incidence of malabsorption increased strikingly from the age of 3 to the age of 5 years, the age effect remained constant after the age of 6 years. The lactose load of 2 g/kg induced a higher incidence of malabsorption in study subjects than 1 g/kg did, and the dose effect increased for those aged below 5 years and decreased above 5 years. Small-intestinal lactase was also studied in 34 children aged from 2 months to 15 years. The lactase activity was highest in children 2 years old or younger, gradually decreasing with increasing age. In conclusion, lactase activity in Chinese children decreases gradually after 3 years of age, a finding that correlates well with the results of the breath hydrogen test.
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PMID:Lactose malabsorption and small-intestinal lactase in normal Chinese children. 312 31

In 122 healthy newborn infants, we studied the relationship between breath hydrogen (H2) production after feedings containing lactose (human milk or commercial formula) in colicky and noncolicky infants at 6 weeks and 3 months. Eighty-three infants (68%) developed colic (mild, moderate, or severe) by 2.6 +/- 1.8 weeks of age (mean +/- SD). Zero time (baseline) breath H2 values were significantly higher in colicky compared with noncolicky infants at both 6 weeks (40.6 +/- 41.4 vs 14.8 +/- 32.9 ppm) and 3 months (27.7 +/- 38.1 vs 8.5 +/- 18.2 ppm). There were significantly more positive breath H2 tests in colicky compared with noncolicky infants at 6 weeks (78% vs 36%) and 3 months (89% vs 45%). Failure to produce H2 throughout the breath H2 test was significantly more frequent in noncolicky compared with colicky infants at 6 weeks (50% vs 18%) and 3 months (43% vs 4%). These findings remained significant even when infants with mild colic (at 6 weeks and 3 months) were included in the noncolicky group. We conclude that colicky infants produce more breath H2 in the fasting state and in response to feedings containing lactose than noncolicky infants produce. This may represent increased lactose malabsorption, differences in colonic bacterial fermentation conditions, or differences in the handling of colonic gas produced.
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PMID:Breath hydrogen response to milk containing lactose in colicky and noncolicky infants. 276 15

The malabsorption of a physiological dose of lactose (0.5 g/kg body weight) was studied in 726 healthy Chinese children, ranging in age from 3 to 18 years, using the breath hydrogen test. The prevalence of lactose malabsorption was found to increase with age; it occurred in less than 15% of preschool-age children and in approximately 45% of younger school-age and 60% of older school-age children. Approximately 70% of adolescents measured showed malabsorption. The critical period of change was from 6 to 7 years of age, with the lactose malabsorption rate rising abruptly from 12 to 43%. The incidence of lactose intolerance in teenagers and adolescents was 27 and 33%, respectively. The great majority of them had only dull abdominal pain. No case of lactose intolerance was seen in children less than 9 years of age. These results indicated that preschool Chinese children can absorb a physiological dose of lactose (equivalent to the average amount of milk consumed daily) without any adverse effects. In contrast, one half of school-age children and two thirds of adolescents were malabsorbers.
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PMID:Developmental changes of lactose malabsorption in normal Chinese children: a study using breath hydrogen test with a physiological dose of lactose. 319 71

The role of lactose malabsorption (LM) was investigated in 32 children (mean age 8.13 +/- 2.46 years) with recurrent abdominal pain (RAP). LM was detected in 75% of them by a lactose breath hydrogen test (LBHT) after a 2-g/kg (max 50-g) load. Of the 18 malabsorbers who participated in a 3-month lactose-free diet (LFD), 14 were judged "improved" and reported lower pain frequency (p less than 0.001). The malabsorbers who improved versus the not improved had comparable past lactose ingestion but were distinguishable on the basis of their lactose absorption capacity (0.36 vs. 0.81 g/kg; p less than 0.01), as subsequently determined by multiple LBHTs with 25-, 12.5-, and 6-g loads. The ratio between past lactose ingestion and lactose absorption was 1.89 in the improved and 0.55 in the not improved groups (p less than 0.01), retrospectively indicating lactose as a possible cause of the symptoms in the improved group. The reintroduction of lactose in amounts not exceeding the absorption capacity into the diet of each malabsorber who had improved with LFD caused relapse in none of the 14 subjects monitored for 2-6 months. In conclusion, LM seems an important cause of symptoms in Italian children with RAP. Assessment of the lactose absorption threshold of each subject of LBHTs provides a basis for reintroduction of "calibrated" amounts of lactose-containing foods (e.g., milk) into the diet.
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PMID:Lactose malabsorption and recurrent abdominal pain in Italian children. 319 72

Small-intestinal absorption of fructose was investigated in healthy human subjects by sequential breath-hydrogen measurements. Fifty-eight percent of 103 subjects produced greater than 20 microL H2/L after consuming 50 g pure fructose in water. About half of those who absorbed fructose incompletely (incomplete absorbers) had abdominal symptoms. Malabsorption of medium doses of pure fructose may therefore be common in man. When 25 g pure fructose was consumed, only 19% of 21 poor absorbers (of 50 g fructose) still produced excess breath H2. When glucose was taken with fructose, the frequency and amount of excessive breath H2 was substantially reduced. This facilitating phenomenon is not generally known but is important because in natural foods fructose occurs in association or in combination (as sucrose) with glucose. Plasma fructose responses were not lower in poor absorbers presumably because these responses depend more on how much fructose passes through the liver than on how much is absorbed.
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PMID:Incomplete absorption of pure fructose in healthy subjects and the facilitating effect of glucose. 320 90

The amounts of hydrogen produced from starch and lactulose were compared to assess the accuracy of the hydrogen breath test with lactulose as standard to quantify starch malabsorption. The mean amounts of hydrogen produced from starch and lactulose were not different in fecal homogenates and in breath excretion after carbohydrate infusions into the cecum. Known amounts of starch infused into the cecum of 18 subjects were compared with amounts calculated from the total excess excretion of hydrogen in breath computed in relation to hydrogen production after the ingestion of 10 g lactulose; calculated amounts were 3.6 +/- 1.0, 9.9 +/- 1.3, and 22.0 +/- 3.4 g for the infusion of 5, 10, and 25 g of starch, respectively. The lactulose hydrogen breath test based on total excess hydrogen volume provides a valid measurement of the mean amount of starch metabolized in the colon in a group of subjects. However, large individual variations preclude its use in a given subject.
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PMID:Starch absorption by healthy man evaluated by lactulose hydrogen breath test. 333 40


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