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Delayed small-intestinal transit in tropical malabsorption.

G C Cook

    British Medical Journal
    |July 22, 1978
    PubMed
    Summary
    This summary is machine-generated.

    This study found that delayed breath hydrogen appearance in patients with tropical malabsorption indicates slow mouth-to-cecum transit. This finding is crucial for understanding gut transit disorders and bacterial overgrowth in tropical diseases.

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    Area of Science:

    • Gastroenterology
    • Tropical Medicine
    • Microbiology

    Background:

    • Tropical malabsorption is a significant health issue for individuals returning from the tropics.
    • Altered gastrointestinal transit and bacterial colonization are implicated in the pathogenesis of tropical malabsorption and related conditions like tropical sprue.
    • Understanding the mechanisms of disease progression is vital for effective treatment strategies.

    Purpose of the Study:

    • To investigate the mouth-cecum transit rate in patients with a history of tropical travel and gastrointestinal symptoms.
    • To determine if delayed transit is a characteristic feature of tropical malabsorption.
    • To explore the relationship between transit time, bacterial overgrowth, and clinical outcomes.

    Main Methods:

    • Utilized the hydrogen breath test following oral lactulose administration to measure mouth-cecum transit time (T).

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  • Recruited 98 patients with a history of tropical travel and 56 healthy controls from diverse ethnic backgrounds.
  • Categorized patients into groups: tropical malabsorption (with varying severity), chronic diarrhea without malabsorption, and healthy controls.

    • Main Results:

    • Mean transit time (T) was significantly delayed in patients with tropical malabsorption compared to controls, confirming abnormally slow mouth-cecum transit.
    • In six patients with tropical malabsorption, a decrease in T was observed post-treatment, correlating with clinical improvement.
    • Three patients with chronic colonic disease and diarrhea also exhibited delayed transit times.

    Conclusions:

    • Delayed mouth-cecum transit is a key feature in patients with tropical malabsorption.
    • Bacterial colonization of the small intestine, a consequence of stasis, plays a critical role in the pathogenesis of tropical malabsorption and tropical sprue.
    • The hydrogen breath test is a valuable tool for assessing gut transit and aiding in the diagnosis and management of these conditions.