Fernández-Bañares F, Esteve-Pardo M, de Leon R, Humbert P, Cabré E, Llovet J M, Gassull M A
Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Am J Gastroenterol. 1993 Dec;88(12):2044-50.
To investigate the relationship of sugar malabsorption to the development of clinical symptoms in functional bowel disease.
Twenty-five consecutive outpatients [five men, 20 women; mean age 38.7 +/- 2.6 (SEM) yr] with functional bowel disease and symptoms suggestive of carbohydrate malabsorption were studied. Twelve healthy subjects [six men, six women; mean age 35.7 +/- 3.7 (SEM) yr] acted as the control group. Sugar malabsorption was assessed by breath-hydrogen test after an oral load of various solutions containing lactose (50 g), fructose (25 g), sorbitol (5 g), fructose plus sorbitol (25 + 5 g), and sucrose (50 g). The severity of symptoms developing after sugar challenge was studied. In addition, the effect on clinical symptoms of a diet free of the offending sugars, compared to a low-fat diet, was assessed.
Frequency of sugar malabsorption was high in both patients and controls, with malabsorption of at least one sugar in more than 90% of the subjects. Median symptom scores after both lactose [median 6; interquartile (IQ) range 3-7] and fructose plus sorbitol (median 2; IQ range 0-4) malabsorption were significantly higher than after sucrose load (median 1; IQ range 0-1.5) in functional bowel disease patients (p = 0.001 and p = 0.007, respectively). However, there were no differences in healthy controls. In addition, symptoms score after both lactose and fructose plus sorbitol malabsorption was significantly higher in patients than in control subjects (p = 0.02 and p = 0.008, respectively). On the other hand, H2 production capacity, as measured following lactulose load, was significantly higher in patients than in controls. The clinical symptoms improved in 40% of the evaluated patients after restriction of the offending sugars.
These results suggest that sugar malabsorption may be implicated in the development of abdominal distress in at least a subset of patients with functional bowel disease.
研究糖吸收不良与功能性肠病临床症状发生之间的关系。
对25例连续性门诊功能性肠病患者[5例男性，20例女性；平均年龄38.7±2.6（标准误）岁]进行研究，这些患者有提示碳水化合物吸收不良的症状。12名健康受试者[6例男性，6例女性；平均年龄35.7±3.7（标准误）岁]作为对照组。口服含乳糖（50克）、果糖（25克）、山梨醇（5克）、果糖加山梨醇（25 + 5克）和蔗糖（50克）的各种溶液后，通过呼气氢试验评估糖吸收不良情况。研究糖激发后出现的症状严重程度。此外，评估与低脂饮食相比，去除有害糖的饮食对临床症状的影响。
患者和对照组中糖吸收不良的发生率都很高，超过90%的受试者至少有一种糖吸收不良。在功能性肠病患者中，乳糖吸收不良[中位数6；四分位间距（IQ）3 - 7]和果糖加山梨醇吸收不良（中位数2；IQ范围0 - 4）后的症状评分中位数显著高于蔗糖负荷后（中位数1；IQ范围0 - 1.5）（分别为p = 0.001和p = 0.007）。然而，健康对照组中没有差异。此外，患者乳糖和果糖加山梨醇吸收不良后的症状评分显著高于对照组受试者（分别为p = 0.02和p = 0.008）。另一方面，患者在口服乳果糖负荷后测得的H2产生能力显著高于对照组。在限制有害糖摄入后，40%的评估患者临床症状有所改善。
这些结果表明，糖吸收不良可能至少在一部分功能性肠病患者的腹部不适发生中起作用。
