Rumessen J J, Gudmand-Høyer E
Department of Gastroenterology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Gastroenterology. 1988 Sep;95(3):694-700. doi: 10.1016/s0016-5085(88)80016-7.
Twenty-five patients with functional bowel disease were given fructose, sorbitol, fructose-sorbitol mixtures, and sucrose. The occurrence of malabsorption was evaluated by means of hydrogen breath tests and the gastrointestinal symptoms, if any, were recorded. One patient could not be evaluated because of lack of H2 production. Based on a cut-off level of 10 ppm rise of H2 concentration, malabsorption was apparent in 13 patients, in 7 of which the calculated absorption capacities were below 15 g. In contrast, in patients given 50 g of sucrose, malabsorption could not be detected. Ingestion of fructose caused marked abdominal distress in patients with demonstrable malabsorption. Ingestion of sucrose in these patients gave less pronounced symptoms of abdominal distress. Malabsorption of a 5-g dose of sorbitol could be detected in 8 of 13 patients. Mixtures of 25 g of fructose and 5 g of sorbitol caused significantly increased abdominal distress, and more than additive malabsorption was found in several cases. The present study shows that pronounced gastrointestinal distress may be provoked by malabsorption of small amounts of fructose, sorbitol, and fructose-sorbitol mixtures in patients with functional bowel disease. The findings may have direct influence on the dietary guidance given to a major group of patients with functional bowel disease and may make it possible to define separate entities in this disease complex.
对25例功能性肠病患者给予果糖、山梨醇、果糖 - 山梨醇混合物和蔗糖。通过氢呼气试验评估吸收不良的发生情况，并记录胃肠道症状（如有）。1例患者因缺乏氢气产生而无法评估。基于氢气浓度升高10 ppm的临界值，13例患者出现明显的吸收不良，其中7例计算出的吸收能力低于15克。相比之下，给予50克蔗糖的患者未检测到吸收不良。果糖摄入会使有明显吸收不良的患者出现明显的腹部不适。这些患者摄入蔗糖时腹部不适症状较轻。13例患者中有8例检测到5克剂量山梨醇的吸收不良。25克果糖和5克山梨醇的混合物导致腹部不适显著增加，并且在一些病例中发现吸收不良超过相加效应。本研究表明，功能性肠病患者中少量果糖、山梨醇和果糖 - 山梨醇混合物的吸收不良可能引发明显的胃肠道不适。这些发现可能对给予一大类功能性肠病患者的饮食指导有直接影响，并可能使在这一疾病复合体中定义不同的实体成为可能。
