Cook G C
Br Med J. 1978 Jul 22;2(6132):238-40. doi: 10.1136/bmj.2.6132.238.
The time of breath hydrogen appearance (T) after oral lactulose was determined in 98 patients in London who had been to the tropics. Fifty-six controls from three different ethnic groups had no evidence of gastrointestinal disease; 23 had tropical malabsorption, which was severe in 10; and 19 had chronic diarrhoea without malabsorption. Mean T was significantly delayed in patients with tropical malabsorption compared with controls, indicating that their mouth-caecum transit rate was abnormally slow. In six patients with tropical malabsorption who were reinvestigated after treatment a fall in the value for T seemed to parallel clinical improvement. Three patients with diarrhoea due to chronic colonic disease had delayed T. Patients with tropical malabsorption have bacterial colonisation of the small intestine, which is important in the pathogenesis of the disease. Bacterial overgrowth, which sometimes occurs after infective diarrhoea in the tropics and gives rise to tropical sprue, is a result of stasis.
在伦敦98名曾去过热带地区的患者中测定了口服乳果糖后呼气中氢气出现的时间（T）。来自三个不同种族的56名对照者没有胃肠道疾病的证据；23名患有热带吸收不良，其中10名病情严重；19名患有慢性腹泻但无吸收不良。与对照组相比，热带吸收不良患者的平均T显著延迟，表明他们的口腔-盲肠转运速率异常缓慢。在6名热带吸收不良患者治疗后再次进行检查时，T值的下降似乎与临床改善情况平行。3名因慢性结肠疾病导致腹泻的患者T延迟。热带吸收不良患者小肠存在细菌定植，这在该疾病的发病机制中很重要。热带地区感染性腹泻后有时会发生细菌过度生长并导致热带口炎性腹泻，这是淤滞的结果。
