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Gastrointestinal Disease
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Justine Turner, Sally Schwartz
Lactose is a disaccharide composed of galactose and glucose, and is the main carbohydrate in milk. Lactose intolerance refers to the inability to digest lactose due to inadequate activity of the lactase enzyme, the most common form of disaccharide deficiency. Primary lactase deficiency is a common condition in which lactase activity falls after weaning and can happen at any point in childhood, adolescence, or adulthood, although it is rare under age 6 years of age. Primary lactose intolerance is highly prevalent in African-American, Native-American, and Asian populations and less common in Northern-European, certain African, and Indian populations. Secondary lactase deficiency is usually due to mucosal injury associated with disease, such as celiac disease or Crohn’s disease.
Nutrition
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
2.17. Biochemical abnormalities in kwashiorkor includehypernatraemia.aminoaciduria.lactase deficiency.low serum albumin.potassium deficiency.
Biochemical Parameters: Childhood Diarrhea and Malabsorption Syndrome
Published in Anil Gupta, Biochemical Parameters and the Nutritional Status of Children, 2020
The undigested lactose is degraded by colonic bacteria. It produces gas and bloating. Lactase deficiency appears after the age of two years in children and it can manifest later in childhood during the adolescent period. Premature babies may develop lactose intolerance and diarrhea, but infants rarely suffer from lactose intolerance. Furthermore, hereditary lactase deficiency is a congenital condition that is rarely found in children (NIDDK 2014; Mayo Foundation 2019a).
The influence of Scandinavian presence on Greenlandic lactase persistence
Published in Scandinavian Journal of Gastroenterology, 2023
Símun Niclasen, Stig Andersen, Nadja Albertsen, Henrik Bygum Krarup
Lactose is the primary saccharide in milk and constitutes 4–5 g/L. It requires enzymatic hydrolysis in the mucosa in the small intestine by lactase into d-glucose and d-galactose before it can be absorbed. In most populations, lactase levels decline after weaning, although at different rates among different people [1]. The ability to produce lactase throughout life is called lactase persistence, as opposed to lactase non-persistence (LNP), and is inherited as an autosomal dominant trait [2]. Differences in lactase activity between lactase persistence and non-persistence can occur by 3 years old or earlier [3]. The inability to effectively digest lactose can be due to adult LNP, to primary (congenital) lactase deficiency caused by coding sequence mutations in the lactase gene, or secondary lactase deficiency, caused by disease in the intestinal mucosa [2,4].
Breathing new life into clinical testing and diagnostics: perspectives on volatile biomarkers from breath
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
Jordan J. Haworth, Charlotte K. Pitcher, Giuseppe Ferrandino, Anthony R. Hobson, Kirk L. Pappan, Jonathan L. D. Lawson
A positive result for SIBO is defined as a rise in hydrogen >20 ppm from the pretest baseline within 90 min after carbohydrate administration whereas methane levels of >10 ppm at any interval during the breath test are used to determine IMO (Figure 4). IMO is a separate indication from SIBO since methane is produced by methanogens, which are archaea, not bacteria, that may overgrow in the small or large bowel [40]. Similarly, an elevation in hydrogen gas >20 ppm from baseline can detect carbohydrate malabsorption. Lactose malabsorption affects over half of the global population, with prevalence much higher in the Middle East compared to Europe (70% versus 28%) [41]. Lactose absorption depends on its hydrolysis by the enzyme lactase, which diminishes in most populations during childhood. Lactase deficiency may be primary (genetic) or secondary (acquired), such as through gastroenteritis, inflammatory bowel disease (IBD), celiac disease, and systemic sclerosis [42]. Genetic tests can identify polymorphisms for primary lactase deficiency but are typically not recommended for clinical purposes [42].
Role of Diet in the Management of Carcinoid Syndrome: Clinical Recommendations for Nutrition in Patients with Neuroendocrine Tumors
Published in Nutrition and Cancer, 2022
Salvatore Artale, Sabrina Barzaghi, Nunziata Grillo, Claudia Maggi, Stefano Lepori, Chiara Butti, Antonella Bovio, Lucia Barbarini, Andrea Colombo, Laura Zanlorenzi, Elena Castiglioni, Alessandra Trojani
In those with more than for 4–7 episodes, a maximum of 10 g/day might be considered (56). Fibers such as whole grains and legumes are excluded, and vegetables and fruits are limited (56). It should be noted that these are therapeutic considerations for diarrhea, and not general recommendations that are in contrast with what mentioned above. For patients with more than seven bouts of diarrhea, hospitalization may be necessary and should be treated with artificial nutrition (56). In order to limit bouts of diarrhea, this nutritional treatment provides a low sugar level and appropriate distribution during the day (56). Small and frequent meals at room temperature and dry foods are recommended (56). Soft drinks are banned because they cause water osmotic pressure in the bowel, causing diarrhea (57). Lactose-containing foods are not allowed in order to avoid abdominal pain and diarrhea for those who are intolerant and have congenital primitive lactase deficiency (68% of global population) (58).