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Carbohydrate malabsorption in acute diarrhea
M Karaböcüoglu1, S Sökücü, G Gökçay
1Institute of Child Health, University of Istanbul, Turkey.
Insights
Carbohydrate malabsorption affects 11% of infants with acute diarrhea, often without clear intolerance symptoms. Intestinal absorption defects are not specific to lactose, impacting overall carbohydrate digestion.
Area of Science:
- Pediatrics
- Gastroenterology
- Nutritional Science
Background:
- Acute diarrhea is a common pediatric illness.
- Carbohydrate malabsorption can contribute to prolonged diarrhea in infants.
- Early diagnosis and management are crucial for infant health.
Purpose of the Study:
- To investigate the prevalence of carbohydrate malabsorption in well-nourished infants with acute diarrhea.
- To assess the clinical presentation of carbohydrate intolerance in this population.
- To identify specific carbohydrate absorption defects.
Main Methods:
- Screening of 245 infants using stool pH and reducing substances.
- Diagnosis of carbohydrate malabsorption based on specific criteria.
- Oral lactose tolerance tests performed on a subset of infants.
- Thin layer chromatography used to analyze stool carbohydrate composition.
Main Results:
- Carbohydrate malabsorption was diagnosed in 11% (28/245) of infants.
- Only one infant presented with clear clinical features of carbohydrate intolerance.
- Lactase deficiency was indicated in 32% of cases via oral lactose tolerance tests.
- Thin layer chromatography revealed diverse monosaccharides in stools, suggesting non-specific absorption defects.
Conclusions:
- Carbohydrate malabsorption is prevalent in infants with acute diarrhea, often presenting subtly.
- Clinical symptoms of intolerance do not always correlate with diagnosed malabsorption.
- Intestinal absorption defects in these infants are frequently not limited to lactose, implying broader carbohydrate digestion issues.
Abstract:
A group of 245 well nourished infants with acute diarrhea were screened for carbohydrate malabsorption by evaluating stool pH and reducing substances in the stools. Carbohydrate malabsorption was diagnosed in 28 cases (11%). Clinical features of carbohydrate intolerance were present in only one case. The duration of diarrhea after admission ranged from 1 to 13 days (mean 3.9 days). An oral lactose tolerance test was consistent with lactase deficiency in 32% of all cases. Thin layer chromatography showed many carbohydrates including monosaccharides in the stools, indicating that the defect in intestinal absorption was not specific for lactose.