Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria; Department of Gastroenterology, General Hospital Steyr, Steyr, Austria; Clinical Institute of Medical and Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
Clinical Institute of Medical and Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
Can J Gastroenterol Hepatol. 2016;2016:4893501. doi: 10.1155/2016/4893501. Epub 2016 Nov 30.
The aim of this retrospective study was to analyze the concomitant prevalence rates for lactose malabsorption (LM), fructose malabsorption (FM), and histamine intolerance (HI) in patients with so far unexplained gastrointestinal (GI) symptoms. A total of 439 outpatients, who presented unclear abdominal discomfort, underwent lactose (50 g) and fructose (25 g) hydrogen (H) breath tests. Additionally, serum diamine oxidase (DAO) measurements were performed. Individuals with low serum DAO activity (<10 U/mL), GI symptoms, and response to histamine-free diet were diagnosed with HI. Of all 439 patients, 341 (77.7%) were found with 7 various GI conditions. In total, 94 (21.4%), 31 (7.1%), and 100 (22.8%) individuals presented LM, FM, or HI only, whereas 116 (26.4%) patients showed an overlap of GI entities investigated here. Interestingly, 89 out of 241 (36.9%) individuals with carbohydrate malabsorption were also diagnosed with HI (LM + HI: 52 [11.8%], FM + HI: 23 [5.2%], and LM + FM + HI 14 [3.2%] individuals). In conclusion different combinations of LM, FM, and HI are present in individuals with unclear abdominal discomfort/pain. In clinical practice we suggest testing for LM, FM, and additional HI in the diagnostic work-up of these patients. Depending on these various diagnoses possible, patients should get an individualized dietary advice.
本回顾性研究旨在分析目前原因不明的胃肠道（GI）症状患者中乳糖吸收不良（LM）、果糖吸收不良（FM）和组胺不耐受（HI）的并发患病率。共有 439 名出现不明原因腹部不适的门诊患者接受了乳糖（50g）和果糖（25g）氢（H）呼气试验。此外，还进行了血清二胺氧化酶（DAO）测量。血清 DAO 活性低（<10U/mL）、有 GI 症状且对无组胺饮食有反应的个体被诊断为 HI。在所有 439 名患者中，有 341 名（77.7%）患有 7 种不同的 GI 疾病。共有 94 名（21.4%）、31 名（7.1%）和 100 名（22.8%）患者仅出现 LM、FM 或 HI，而 116 名（26.4%）患者表现出这里研究的 GI 实体重叠。有趣的是，241 名碳水化合物吸收不良患者中有 89 名（36.9%）也被诊断为 HI（LM+HI：52[11.8%]，FM+HI：23[5.2%]和 LM+FM+HI：14[3.2%]）。总之，在出现不明原因腹部不适/疼痛的个体中存在 LM、FM 和 HI 的不同组合。在临床实践中，我们建议在这些患者的诊断中检测 LM、FM 和额外的 HI。根据这些不同的诊断，患者应获得个性化的饮食建议。
