Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders
Article first published online: 15 APR 2009
© 2009 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 30, Issue 2, pages 165–174, July 2009
How to Cite
BARRETT, J. S., IRVING, P. M., SHEPHERD, S. J., MUIR, J. G. and GIBSON, P. R. (2009), Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders. Alimentary Pharmacology & Therapeutics, 30: 165–174. doi: 10.1111/j.1365-2036.2009.04018.x
- Issue published online: 26 JUN 2009
- Article first published online: 15 APR 2009
- Publication data Submitted 22 February 2009 First decision 6 March 2009 Resubmitted 12 April 2009 Accepted 13 April 2009 Epub Accepted article 15 April 2009
Background Fructose malabsorption, lactose malabsorption and an early rise in breath hydrogen after lactulose (ERBHAL) may play roles in induction of symptoms in gastrointestinal conditions.
Aim To compare prevalence and interactions of fructose malabsorption, lactose malabsorption and ERBHAL among healthy subjects and those with chronic intestinal disorders using consistent breath hydrogen testing methodologies.
Methods Consecutive series of Caucasian patients with Crohn’s disease (n = 91), ulcerative colitis (56), functional gastrointestinal disorders (FGID) (201), coeliac disease (136) and 71 healthy volunteers underwent breath hydrogen testing using lactulose, fructose and lactose.
Results Early rise in breath hydrogen after lactulose occurred more commonly in healthy controls (39%) than in Crohn’s disease (20%) and untreated coeliac disease (14%; P < 0.008), but not FGID (27%), ulcerative colitis (26%) or treated coeliac disease (29%). Fructose malabsorption was more frequent in Crohn’s disease (61%) than other groups (33–44%, P < 0.05). Lactose malabsorption was most common in Crohn’s disease (42%) and ulcerative colitis (40%) and uncommon (10%) in 79 patients with newly diagnosed coeliac disease. In Crohn’s disease, concurrent Fructose malabsorption and lactose malabsorption was most common (29%), and the association of fructose malabsorption with ERBHAL seen overall (62%) was not observed (36%, P < 0.0001).
Conclusions Carbohydrate malabsorption and ERBHAL are normal physiological phenomena. The abnormal patterns observed in Crohn’s disease may have pathogenic importance.