Beneficial effects of fasting and low carbohydrate diet in D-lactic acidosis associated with short-bowel syndrome.

A case of D-lactic acidosis in an 18-yr-old man with a short bowel is reported. The diagnosis, suspected on clinical grounds, was confirmed by serum and urine levels of D-lactate. Our studies revealed that an ad libitum diet was associated with elevated D-lactate levels and "nothing per oral" and 10% carbohydrate diet regimens caused a drop in D-lactate levels. We recommend npo and low carbohydrate diet as preferred alternatives to antibiotics in some patients with D-lactic acidosis. The literature is reviewed.