Carbohydrate intolerance
https://doi.org/10.22416/1382-4376-2017-27-5-94-104
Abstract
Aim of review. To present the modern concept on etiology and pathogenesis of food intolerance, to analyze the modern strategy of diagnosis and treatment of carbohydrate intolerance. Key points. Patients, who presented with abdominal pain, diarrhea, flatulence at the absence of organic diseases should be investigated to exclude intolerance of nutritional components, first of all - carbohydrates. If food intolerance was confirmed, high performance treatment methods should be applied including dietary modification with elimination of intolerable food products, addition of specific enzyme preparations to the treatment mode. Conclusion. Carbohydrate intolerance results in abdominal pain, flatulence and diarrhea in generally healthy population and patients with functional gastrointestinal diseases. Early detection of integrated agentт and its elimination from the ration will provide significant decrease in symptom severity.
About the Authors
V. O. Kaybysheva
Federal state autonomous educational institution of higher education «Pirogov Russian National Research Medical University»
Russian Federation
Russian Federation
Ye. K. Baranskaya
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
References
1. Ивашкин В.Т., Шептулин А.А., Склянская О.А. Синдром диареи. М.: ГЭОТАР-Медицина; 2002. 185 с.
2. Коротько Г.Ф. Пищеварение - естественная технология. Краснодар: Эдви; 2010. 304 с.
3. Berni Canani R., Pezzella V., Amoroso A. et al. Diagnosing and Treating Intolerance to Carbohydrates in Children. Nutrients 2016, 10;8(3):157.
4. Lomer M.C.E. The aetiology, diagnosis, mechanisms and clinical evidence for food intolerance. Aliment Pharmacol Ther 2015; 41:262-75.
5. Malik V.S., Schulze M.B., Hu F.B. Intake of sugar sweetened beverages and weight gain: A systematic review. Am J Clin Nutr 2006; 84:274-88.
6. Hammer H.F., Hammer J. Diarrhea caused by carbohydrate malabsorption. Gastroenterol Clin N Am 2012; 41:611-27.
7. Bohn L., Storsrud S., Tornblom H. et al. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol 2013; 108:634-41.
8. Hayes P.A., Fraher M.H., Quigley E.M. Irritable bowel syndrome: the role of food in pathogenesis and management. Gastroenterol Hepatol 2014; 10:164-74.
9. Hayes P., Corish C., O’Mahony E. et al. A dietary survey of patients with irritable bowel syndrome. J Hum Nutr Diet 2014; 27:36-47.
10. Monsbakken K., Vandvik P., Farup P. Perceived food intolerance in subjects with irritable bowel syndrome - Etiology, prevalence and consequences. Eur J Clin Nutr 2006; 60:667-72.
11. Simren M., Mansson A., Langkilde A.M. et al. Foodrelated gastrointestinal symptoms in the irritable bowel syndrome. Digestion 2001; 63:108-15.
12. Hayes P., Corish C., O’Mahony E., Quigley E.M. A dietary survey of patients with irritable bowel syndrome. J Hum Nutr Diet 2014; 27:36-47.
13. Campbell A.K., Matthews S.B. Bacterial metabolic «toxins»: A new mechanism for lactose and food intolerance, and irritable bowel syndrome. Toxicology 2010; 278:268-76.
14. De Magistris L., Familiari V., Pascotto А. et al. Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives. J Pediatr Gastroenterol Nutr 2010; 51:418-24.
15. Millward C. Glutenand casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev 2008; 2.
16. Jackson J., Eaton W., Cascella N. et al. Gluten sensitivity and relationship to psychiatric symptoms in people with schizophrenia. Schizophr Res 2014; 159(0):539-42.
17. De Magistris L., Familiari V, Pascotto A. et al. Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives. J Pediatr Gastroenterol Nutr 2010. 51(4):418-24.
18. Peters S.L. Biesiekierski J.R., Yelland G.W. et al. Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity an exploratory clinical study. Aliment Pharmacol Ther 2014; 39(10):1104-12.
19. Matthews S.B., Waud J.P. Systemic lactose intolerance: a new perspective on an old problem. Postgrad Med J 2005; 81:167-73.
20. Diekmann L., Pfeiffer K., Naim H.Y. Congenital lactose intolerance is triggered by severe mutations on both alleles of the lactase gene. BMC Gastroenterol 2015; 15:36.
21. Di Rienzo T., D’angelo G., D’aversa F. et al. Lactose intolerance: from diagnosis to correct management. Eur Rev Med Pharmacol Sci 2013; 17:18-25.
22. Enattah N.S., Sahi T., Savilahti E. et al. Identification of a variant associated with adult-type hypolactasia. Nat Genet 2002; 30:233-7.
23. Khabarova Y., Grigoryeva V., Tuomisto S. et al. High prevalence of lactase non-persistence among indigenous nomadic Nenets, north-west Russia. Int J Circumpolar Health 2012 Apr 25;71:1-6.
24. Zhao J., Fox M., Cong Y. et al. Lactose intolerance in patients with chronic functional diarrhoea: The role of small intestinal bacterial overgrowth. Aliment Pharmacol Ther 2010; 31:892-900.
25. Tomba C., Baldassarri A., Coletta M. et al. Is the subjective perception of lactose intolerance influenced by the psychological profile? Aliment Pharmacol Ther 2012; 36:660-9.
26. Mattar R., de Campos Mazo D.F., Carrilho F.J. Lactose intolerance: diagnosis, genetic, and clinical factors. Clin Exp Gastroenterol 2012;5:113-21.
27. Shaukat A., Levitt M.D., Taylor B.C. et al. Systematic review: effective management strategies for lactose intolerance. Ann Intern Med 2010 Jun 15;152(12):797803.
28. Montalto M., Curigliano V., Santoro L. et al. Management and treatment of lactose malabsorption. World J Gastroenterol 2006;12(2):187-91.
29. Labayen I., Forga L., González A. et al. Relationship between lactose digestion, gastrointestinal transit time and symptoms in lactose malabsorbers after dairy consumption. Aliment Pharmacol Ther 2001 Apr;15(4):543-9. Национальная школа гастроэнтерологов, гепатологов =0хщwww.gastro-j.ru National college of gastroenterologists, hepatologists
30. Vallaeys L., van Biervliet S., de Bruyn G. et al. Congenital glucose-galactose malabsorption: A novel deletion within the SLC5A1 gene. Eur J Pediatr 2013; 172:409-11.
31. Bothinah Ghazali1, Sultan A. Almedhesh, Ali M. Alsuheel et al. Congenital glucose-galactose malabsorption: A rare cause of chronic diarrhea. Intern J Med Medical Scienc 2014; 6(2):59-62.
32. Gomara R.E., Halata M.S. Fructose intolerance in children presenting with abdominal pain. J Pediatr Gastroenterol Nutr 2008; 47:303-8.
33. Jones H.F., Butler R.N., Brooks D.A. Intestinal fructose transport and malabsorption in humans. Am J Physiol Gastrointest Liver Physiol 2011; 300:G202-G206.
34. Ledochowsky M., Widner B., Bair H. et al.Fructose and sorbitol reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers. Scand J Gastroentrol 2000; 35:1048-52.
35. Frieling T. Fructose malabsorption: how much fructose can a healthy subject tolerate? Digestion 2011; 84:269-72.
36. Puntis J.W., Zamvar V. Congenital sucrase-isomaltase deficiency: Diagnostic challenges and response to enzyme replacement therapy. Arch Dis Child 2015; 100:869-71.
37. Uhrich S., Wu Z., Huang J.-Y. et al. Four mutations in the SI gene are responsible for the majority of clinical symptoms of CSID. J Pediatr Gastroent Nutr 2012; 55(Suppl 2):S34S35.
38. Robayo-Torres C.C., Opekun A.R., Quezada-Calvillo R. et al. 13C-breath tests for sucrose digestion in congenital sucrase isomaltase-deficient and sacrosidase-supplemented patients. J Pediatr Gastroenterol Nutr 2009; 48:412-18.
39. Treem W.R. Clinical aspects and treatment of congenital sucrase-isomaltase deficiency. J Pediatr Gastroenterol Nutr 2012; 55:S7-S13.
40. Macdonald S. Carbohydrate intolerances. In: Shaw V. ed. Clinical paediatric dietetics, 4th edn. Chichester: Wiley Blackwell; 2015. P. 121-3.
41. Murray I.A., Coupland K., Smith J.A. et al. Intestinal trehalase activity in a UK population: estabilishing a normal range and the effect of disease. Br J Nutr 2000: 83; 241-5.
42. Arola H., Koivula T., Karvonen A.L. et al. Low trehalase activity is associated with abdominal symptoms caused by edible mushrooms. Scand J Gastroenterol 1999 Sep; 34(9):898-903. PubMed PMID: 10522609.
43. Gibson P.R. History of the low FODMAP diet. J Gastroenterol Hepatol 2017 Mar; 32(Suppl 1):5-7. doi: 10.1111/jgh.13685. Review. PubMed PMID: 28244673.
44. Ganiats T.G., Norcross W.A., Halverson A.L. et al. Does Beano prevent gas? A double-blind crossover study of oral alpha-galactosidase to treat dietary oligosaccharide intolerance. J Fam Pract 1994; 39(5):441-5.
45. Hillila M., Fakkila M.A., Sipponen T. et al. Does oral alpha-galactosidase relieve irritable bowel symptoms? Scand J Gastroenterol 2016; 51(1):16-21.
46. Di Nardo G., Oliva S., Ferrari F. et al. Efficacy and tolerability of alpha-galactosidase in treating gas-related symptoms in children. A randomized, double-blind, plactbo-controlled trial. BMC Gastroenterol 2013; 13:142.
47. Banasiewicz T., Krokowicz L., Stojcev Z. et al. Microencapsulated sodium butyrate reduces the frequency of abdominal pain in patients with irritable bowel syndrome. Colorectal Dis 2013; 15:204-9.
48. Kannampalli P., Shaker R., Sengupta J.N. Colonic butyratealgesic or analgesic? Neurogastroenterol Motil 2011; 23:975-9.
49. Tana C., Umesaki Y., Imaoka A. et al. Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome. Neurogastroenterol Motil 2010; 22(5):512-9.
50. Monsbakken K., Vandvik P., Farup P. Perceived food intolerance in subjects with irritable bowel syndrome - Etiology, prevalence and consequences. Eur J Clin Nutr 2006; 60:667-72.
51. Simren M., Mansson A., Langkilde A.M. et al. Foodrelated gastrointestinal symptoms in the irritable bowel syndrome. Digestion 2001; 63:108-15.
52. Miller L.E., Tennilä J., Ouwehand A.C. Efficacy and tolerance of lactitol supplementation for adult constipation: a systematic review and meta-analysis. Clin Exp Gastroenterol 2014; 7:241-8.
53. Hayes P., Corish C., O’Mahony E., Quigley E.M. A dietary survey of patients with irritable bowel syndrome. J Hum Nutr Diet 2014; 27:36-47.
54. Wilder-Smith C.H., Materna A., Wermelinger C. et al. Fructose and lactose intolerance and malabsorption testing: the relationship with symptoms in functional gastrointestinal disorders. Aliment Pharmacol Ther 2013; 37:1074-83.
55. Saad R.J., Chey W.D. Breath tests for gastrointestinal disease: the real deal or just a lot of hot air? Gastroenterology 2007; 133(6):1763-6.
Review
For citations:
Kaybysheva V.O., Baranskaya Ye.K. Carbohydrate intolerance. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(5):94-104. (In Russ.) https://doi.org/10.22416/1382-4376-2017-27-5-94-104
Views:
3918
Email this article 
