Is Carbohydrate Intolerance Associated With Carbohydrate Malabsorption in Disorders of Gut-Brain Interaction?

Area of Science:

• Gastroenterology
• Functional Bowel Disorders
• Dietary Intolerances

Background:

• Disorders of gut-brain interaction (DGBI) encompass a range of functional gastrointestinal conditions.
• Carbohydrate intolerance, including lactose and fructose intolerance, is increasingly recognized as a potential contributor to DGBI symptoms.

Purpose of the Study:

• To determine the prevalence of carbohydrate intolerance in patients diagnosed with DGBI.
• To identify patient characteristics and symptom profiles associated with carbohydrate intolerance within this population.

Main Methods:

• Prospective study including 301 DGBI patients undergoing lactose and fructose breath tests.
• Carbohydrate intolerance defined by a ≥20 mm increase in Visual Analog Scale for specific symptoms post-ingestion.
• Adult Carbohydrate Perception Questionnaire used to assess symptom changes.

Main Results:

• 59.1% of DGBI patients exhibited carbohydrate intolerance.
• Intolerant patients were more likely female, had multiple DGBI, lactose maldigestion, fructose malabsorption, and reported worse quality of life.
• Lactose maldigestion and somatic symptom severity were independently associated with carbohydrate intolerance.

Conclusions:

• Carbohydrate intolerance is prevalent in DGBI patients, significantly impacting their quality of life and symptom burden.
• Further investigation is warranted into the mechanisms underlying carbohydrate intolerance in DGBI patients, particularly those without malabsorption/maldigestion.