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Respiratory system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
7.24. Which of the following statements is/are true of fibrocystic disease of the pancreas?Intestinal disaccharidase levels are low.Prognosis is unchanged even with optimal management.There is an incidence of 1 in 4 of this condition in the offspring of unaffected siblings.There is an increased incidence of neonatal bowel obstruction.Neonatal screening for immunoreactive trypsin will establish early diagnosis in more than 98% of cases.
Celiac Disease in Infancy and Childhood
Published in Tadeusz P. Chorzelski, Ernst H. Beutner, Vijay Kumar, Tadeusz K. Zalewski, Serologic Diagnosis of Celiac Disease, 2020
Thomas Rossi, Tadeusz Zalewski
The specific therapy for celiac disease is a gluten-free diet which excludes wheat, barley, oats, and rye. Strict adherence to this diet often leads to improvement in the clinical symptoms within a few hours; full remission, however, may take weeks or months. Continuation of and recurrence of symptoms suggests either deliberate or inadvertent gluten ingestion. Special serum studies which have been found to distinguish patients who are non-compliant with the prescribed gluten-free diet are described in Chapter 3 and Reference 58. Also, transient disaccharidase deficiency, particularly lactase deficiency, secondary to mucosal atrophy must be considered in patients who continue to be symptomatic. Alternatively, exocrine pancreatic insufficiency, most probably related to malnutrition and hypoproteinemia, may be associated with celiac disease and account for continuation of steatorrhea.75 Recently we have observed two children, ages 4 and 9 years, with this association. Pancreatic enzyme supplementation may be helpful in this situation.
The digestive system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
The disaccharide molecules, primarily maltose, are presented to the brush border of the absorptive cells. As the disaccharides are absorbed, disaccharidases (maltase, sucrase, and lactase) split these nutrient molecules into monosaccharides (glucose, fructose and galactose).
Sucrose intolerance in adults with common functional gastrointestinal symptoms
Published in Baylor University Medical Center Proceedings, 2022
Christine L. Frissora, Satish S. C. Rao
CSID, or primary sucrose malabsorption, is a rare genetic disorder associated with one or more mutations in the SI gene.13 Secondary or acquired sucrose intolerance is more common and occurs as a result of mucosal damage and brush border injury from organic causes. The gold standard for diagnosing sucrase deficiency is disaccharidase testing of duodenal biopsies obtained during an upper endoscopy.14 One recent study reported a 9.3% incidence of sucrase deficiency among 27,875 pediatric GI patients.15 In a smaller pilot study, the incidence of sucrase deficiency was 14.3% in 28 pediatric GI patients.16 A recent retrospective study of duodenal biopsies with normal histology from adults with unexplained GI symptoms found that 9.2% (11/120) had pan-disaccharidase deficiency, including sucrase deficiency.17
Efficacy and safety of plecanatide in treating constipation predominant irritable bowel syndrome
Published in Expert Opinion on Pharmacotherapy, 2018
The pathophysiology of IBS is multifactorial, partly because multiple abnormalities of GI function produce a limited number of overlapping symptoms. Treatment often addresses a single symptom, bowel movement frequency, rather than dealing with the elusive pathophysiology of IBS-C in an individual patient. Regarding the single symptom treatment approach to treat IBS-C, therapeutic failure exceeds therapeutic success. Recent US FDA guidance for development of drugs for IBS-C reinforces the recognition of multiple symptoms in patients with IBS-C as the expectation for registration now requires that two symptoms improve – constipation defined by the number of complete spontaneous bowel movements (CSBMs) and abdominal pain. Occasionally in a subset of IBS patients, a specific pathophysiologic mechanism becomes clear and the diagnosis of IBS is replaced with the newly found ‘disease’. For example, once the importance of disaccharidase deficiency was understood, the IBS symptoms associated with lactose intolerance allowed the diagnosis of IBS in these patients to be abandoned in favor of a pathophysiologically based explanation for symptoms associated with lactase deficiency. Until the pathophysiology of IBS is completely understood, treatment will continue to be symptom based. In the complex IBS arena, plecanatide has been shown to offer important symptomatic relief in many patients with IBS-C.
Redox modulatory protective effects of ω-3 fatty acids rich fish oil against experimental colitis
Published in Toxicology Mechanisms and Methods, 2019
Mohita Sharma, Ramanpreet Kaur, Kuldeep Kaushik, Naveen Kaushal
Studies indicate considerable variations in the specific activity of intestinal marker disaccharidases, during UC. Currently, a significant decrease (p < 0.05) in the specific activities of these enzymes (sucrase and lactase) in the Group D (DSS + CO) animals was observed when compared with Group A (FO), Group B (CO), and Group C (DSS + FO) (Figure 2(D,E)). Administration of FO in Group C (DSS + FO) clearly had a protective effect in terms of restoring the activities of these enzymes toward normal, though the levels still seem significantly reduced (p < 0.05) compared to Group A (FO).