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[Disaccharidase deficiency and functional bowel diseases]
A I Parfenov1, O V Akhmadullina1, E A Sabelnikova1
1Moscow Clinical Research-and-Practical Center, Moscow Healthcare Department, Moscow, Russia.
Terapevticheskii Arkhiv
|May 18, 2017
Summary
Functional bowel diseases (FBD) are often caused by reduced intestinal carbohydrase activity. Diagnosing disaccharidase deficiency, linked to specific triggers, offers a more precise approach for FBD patients.
Area of Science:
- Gastroenterology
- Digestive Physiology
- Clinical Medicine
Background:
- Functional bowel diseases (FBD) encompass a range of disorders affecting gut function.
- The role of intestinal enzyme activity in FBD pathogenesis requires further elucidation.
Purpose of the Study:
- To investigate the activity of key intestinal carbohydrases (glucoamylase, maltase, sucrose, lactase) in patients with FBD.
- To determine the association between carbohydrase deficiencies and the etiology/pathogenesis of FBD.
Main Methods:
- Examined 74 FBD patients (Rome IV criteria) using duodenal biopsy specimens.
- Assessed small intestine mucosa (SIM) carbohydrase activity via modified Dahlquist-Trinder method.
- Categorized FBD subtypes including IBS and functional diarrhea/constipation.
Main Results:
- High prevalence of disaccharidase deficiencies: lactase (87.8%), glucoamylase (85.1%), sucrose (51.3%), maltase (48.6%).
- Reduced activity of 1-3 carbohydrases found in 63.5% of patients; all enzymes reduced in 31.1%.
- Only 5.4% of patients exhibited normal enzymatic activity.
Conclusions:
- Decreased small intestine mucosa (SIM) carbohydrase activity is a primary cause of intestinal symptoms in the majority of FBD patients.
- Disaccharidase deficiency, especially when linked to identified damaging agents (e.g., NSAIDs, antibiotics), warrants consideration for a more precise FBD diagnosis.
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