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Fat absorption in persistent diarrhoea using 13C-labelled trioctanoin breath test
K A Abbas1, R Bilal, M I Sajjad
1Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
Insights
Persistent diarrhea in children does not significantly impair intestinal fat absorption. A breath test using labeled triglyceride ([13C]trioctanoin) showed similar absorption rates in children with and without persistent diarrhea.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Medical Diagnostics
Background:
- Persistent diarrhea is a common childhood illness.
- Intestinal fat absorption is crucial for nutrient uptake.
- Understanding fat absorption in persistent diarrhea is important for management.
Purpose of the Study:
- To investigate intestinal fat absorption in children with persistent diarrhea.
- To compare fat absorption in children with persistent diarrhea to healthy children.
- To assess the utility of the breath test for evaluating fat malabsorption.
Main Methods:
- Utilized the breath test technique for absorption studies.
- Administered labeled triglyceride ([13C]trioctanoin) orally.
- Monitored 13CO2 excretion in breath over 6 hours using isotope ratio mass spectrometry.
- Constructed excretion curves and calculated areas under the curve for comparison.
Main Results:
- Peak 13CO2 excretion occurred earlier in children with diarrhea (average 150 min) versus normal children (average 195 min).
- Peak excretion levels and mean areas under the curve were not significantly different between groups.
- Results suggest no significant impairment of medium-chain triglyceride absorption in studied cases.
Conclusions:
- Intestinal absorption of medium-chain triglycerides is not significantly impaired in children with persistent diarrhea.
- The breath test is a viable method for assessing fat absorption in pediatric populations.
- Findings contribute to understanding the pathophysiology of persistent diarrhea.
Abstract:
A study was undertaken to investigate intestinal fat absorption in young children suffering from persistent diarrhoea in comparison with normal children of similar age. Absorption studies were performed using the breath test technique. Following oral administration of labelled triglyceride ([13C]trioctanoin), interval breath sampling was done for 6 h. The time course of excretion of 13CO2 in the breath was determined by isotope ratio mass spectrometric analysis of the gas samples. Excretion curves were constructed from the mean values of 13CO2 dose (per cent) excreted at each time point in breath samples and areas under the curve were determined for diarrhoea cases as well as for normal subjects. The time course of 13CO2 excretions and areas under the curve thus obtained were compared with each other and also with a reference study in which data from known malabsorption cases were available. The time of peak 13CO2 excretion in diarrhoea cases ranged from 60 to 240 min (average 150 min) compared with 120 to 270 min (average 195 min) for normal subjects, the level of peak of 13CO2 excreted/h was 4.8 +/- 1.2 per cent in diarrhoea cases and 5.3 +/- 2.3 per cent in normal children (NS). Mean areas under the curve for the two groups were 18.9 +/- 3.4 per cent for normal and 17.6 +/- 4.1 per cent dose 13CO2 excreted/6 h for diarrhoea cases (NS). These results indicate that intestinal absorption of medium chain triglycerides was not impaired significantly in the cases of persistent diarrhoea studied.