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Do I Have IBS?
Published in Melissa G. Hunt, Aaron T. Beck, Reclaim Your Life From IBS, 2022
Melissa G. Hunt, Aaron T. Beck
Another possible cause of GI symptoms is lactose intolerance. Lactose intolerance occurs when the small intestine does not produce the enzyme lactase, which breaks down the sugar lactose that is found in all kinds of milk. What are the symptoms of lactose intolerance? Abdominal pain, gas, bloating, and diarrhea, of course! Interestingly, all human beings produce the lactase enzyme during the first few years of life, because lactose is found in human breast milk and is necessary for early development. In many people of the world (especially Asians, Southeast Asians, Native Americans, and some Africans), lactase production stops around age two – the time that toddlers would typically be weaned. Interestingly, traditional Asian and Native American cuisines typically contain no milk products, consistent with the fact that folks from those ethnic backgrounds do indeed tend to be lactose-intolerant. People in those cultures found ways to combine legumes (beans or soybeans) with grains (corn, rice, or wheat) to make complete proteins and provide full nutrition (and delicious and highly varied cuisines!).
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.
Answers
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Irritable bowel syndrome is a primarily functional disorder which covers a large number of intestinal symptoms and classically was a diagnosis of exclusion. Whilst aetiology is not certain, gastrointestinal motility and visceral perception problems are mooted as possibilities. Commoner in young females, symptoms include left-sided or central abdominal pain, bloating, changing bowel habit, nausea and symptoms of reflux. Symptoms may be cyclical with menstruation or related to psychological stressors. Treatment is symptomatic and many specialties may be involved. Constipation can be treated with increased dietary fibre with ispaghul husk, whilst diarrhoea can be treated with bulking agents and loperamide. Antispasmodics such as mebeverine can be used if colicky pain or spasm is prominent. Exclusion diets can help if lactose intolerance is involved. Psychological therapy can help with concurrent stress and depression. It is important however to screen for worrying symptoms such as weight loss and per rectal bleeding that may have a serious cause.
Directly compressible formulation of immediate release rosuvastatin calcium tablets stabilized with tribasic calcium phosphate
Published in Pharmaceutical Development and Technology, 2022
Daniel Zakowiecki, Tobias Hess, Krzysztof Cal, Barbara Mikolaszek, Grzegorz Garbacz, Dorota Haznar-Garbacz
It should be noted here that the reference product during stability testing was stored in LDPE plastic bags, not in its original packaging (i.e. blisters of aluminum laminate/aluminum foil), which certainly influenced its stability. Furthermore, by comparing the compositions of the formulations, one can notice that the main constituent of the reference product is lactose monohydrate (AstraZeneca 2020; EMC 2021). The results of the drug–excipient compatibility study clearly showed that of the excipients tested, lactose monohydrate was the least likely to stabilize RSC (see Figure 1). Therefore, in the case of RSC formulations, elimination of lactose monohydrate seems to be reasonable. Nevertheless, the tablets developed in the course of this study when stored under the same conditions showed satisfactory chemical stability. From a drug manufacturer's perspective, the proposed formulations F1 and F2 offer the possibility of using fewer tablet ingredients, which contributes to simplifying manufacturing operations as well as paperwork. Combined with the prospect of producing tablets using a DC process, this gives the potential for reduction of the total cost of manufacturing of such types of tablets. Last but not least, the elimination of lactose from the formulation may prove particularly beneficial to patients who suffer from severe lactose intolerance. In the case of such patients who insist on treatment with lactose-free products or who need to take medications for extended periods of time, this can positively impact the patient’s medication compliance (Eadala et al. 2009; Mill et al. 2018).
Food and beverages promoting elderly health: six food-based dietary guidelines to plan good mixed meals for elderly South Africans
Published in South African Journal of Clinical Nutrition, 2021
Sanjoy Saha, Upasana Mukherjee, Makenzie Miller, Li-Ling Peng, Carin Napier, Heleen Grobbelaar, Wilna Oldewage-Theron
In a review of 53 global dairy FBDGs, all included milk, and most (46) included milk products, yogurt and cheese.128 Adequate quantities of milk provide all the essential amino acids for muscle health and strength.129 It is thus recommended that an individual who is lactose intolerant should not avoid milk completely, but rather consume other milk products such as yoghurt or fermented milk products.126,130,131 Milk and milk products are often used to complement other foods. Staple foods such as maize and bread lack lysine amino acid and therefore milk is used with maize or bread to acquire all essential amino acids from the diet.131 Many milk and milk products, including low-fat cheese, can be easily consumed by the elderly and even by those who have dental problems.131
A Randomized Controlled Pilot Exercise and Protein Effectiveness Supplementation Study (EXPRESS) on Reducing Frailty Risk in Community-Dwelling Older People
Published in Journal of Nutrition in Gerontology and Geriatrics, 2021
Agathe Daria Jadczak, Renuka Visvanathan, Robert Barnard, Natalie Luscombe-Marsh
Participant retention is often cited as another issue affecting the quality of studies. In our research we found that whilst the interventions were safe, there were tolerability issues related to the nutritional supplementation; this is something that we46 and other groups47 had noted previously when using commercial products.46,47 Difficulty ingesting the protein drinks, and tolerability of the drinks once consumed resulted in early withdrawals from this study. Therefore, sample size estimation for future studies of this nature should allow for a dropout rate of ∼25%. Those that remained in the study reported high compliance with both types of protein supplements (i.e., 90.3%), which conforms to findings from other studies that investigated the effects of dairy proteins. For example, Fielding et al.,47 as well as Collins et al.,48 also reported high compliance to twice daily 20 g supplements of whey protein in combination with resistance-based exercise despite undesirable gastrointestinal effects. Lactose intolerance is often cited as the cause of gastrointestinal issues in response to dairy. However, the whey protein isolate used in this study had negligible lactose, and known lactose intolerance was an exclusion criterion. Since whey has been demonstrated to empty from the stomach more rapidly than other proteins,49 it is plausible that rapid gastric emptying caused the bloating, nausea and diarrhea experienced by some participants in this study; these are all symptoms of idiopathic accelerated gastric emptying.50