Related Experiment Videos
Intestinal glucoamylase & other disaccharidases in children with protracted diarrhoea
1Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
Insights
Children with protracted diarrhea often have reduced digestive enzyme activity. Many may not tolerate lactose, requiring lactose-free diets, while some with severe injury may need short-chain glucose polymers.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Digestive Physiology
Background:
- Protracted diarrhea in children is often associated with malnutrition and feeding difficulties.
- Intestinal brush border enzyme deficiencies can contribute to malabsorption and failure to thrive.
Purpose of the Study:
- To investigate the activities of brush border enzymes (lactase, sucrase, glucoamylase) in children with protracted diarrhea.
- To correlate enzyme activity with the degree of jejunal mucosal injury and clinical presentation.
Main Methods:
- Jejunal mucosal biopsy specimens were obtained from 34 children with protracted diarrhea and failure to thrive.
- Enzyme activities (lactase, sucrase, glucoamylase) were measured and compared to 8 healthy controls.
- Histological examination assessed the degree of mucosal injury.
Main Results:
- All three enzymes showed decreased activity, correlating with increased mucosal injury.
- Lactase activity was reduced even in children with normal mucosa.
- Glucoamylase and sucrase were significantly reduced only with evident mucosal injury.
Conclusions:
- Most children with protracted diarrhea may require lactose-free diets, potentially starch-based.
- Severe mucosal injury may necessitate diets based on short-chain glucose polymers.
- Further metabolic balance studies are recommended to validate these findings.
Abstract:
Brush border lactase, sucrase and glucoamylase activities were assessed in jejunal mucosal biopsy specimens from 34 children (median age 11 months; range 1.5-38) having protracted diarrhoea with failure to thrive and 8 well nourished children with normal jejunal mucosal histology (median age 10.2 months; range 2-37). All enzymes showed progressive decrease in activity which was directly in relation to increasing degree of mucosal injury (P less than 0.002). Lactase was significantly reduced even in patients with protracted diarrhoea and normal mucosa (P less than 0.05). Glucoamylase and sucrase were significantly reduced only in the presence of mucosal injury (P less than 0.01). Our data suggest that most children with protracted diarrhoea may not tolerate lactose containing feeds and may need lactose-free diets preferably based on starch. A small number of children with protracted diarrhoea, who have severe mucosal injury may not be able to handle even starch and may require diets based on short chain glucose polymers. The findings of this study, need to be corroborated with well-controlled metabolic balance studies.