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Routine disaccharidase testing: are we there yet?
Curr Opin Gastroenterol. 2020 Mar; 36(2):101-109.CO

Abstract

PURPOSE OF REVIEW

Disaccharidase testing, as applied to the evaluation of gastrointestinal disturbances is available but it is not routinely considered in the diagnostic work-up. The purpose of this review was to determine if disaccharidase testing is clinically useful and to consider how the results could alter patient management.

RECENT FINDINGS

Indicate that carbohydrate maldigestion could contribute functional bowel disorders and negatively impact the fecal microbiome. Diagnostic techniques include enzyme activity assays performed on random endoscopically obtained small intestinal biopsies, immunohistochemistry, stable isotope tracer and nonenriched substrate load breath testing, and genetic testing for mutations. More than 40 sucrase--isomaltase gene variants coding for defective or reduced enzymatic activity have been reported and deficiency conditions are more common than previously thought.

SUMMARY

The rationale for disaccharidase activity testing relates to a need to fully assess unexplained recurrent abdominal discomfort and associated symptoms. All disaccharidases share the same basic mechanism of mucosal expression and deficiency has far reaching consequences. Testing for disaccharidase expression appears to have an important role in symptom evaluation, but there are accuracy and logistical issues that should be considered. It is likely that specific recommendations for patient management, dietary modification, and enzyme supplementation would come from better testing methods.

Authors+Show Affiliations

Department of Medicine. Department of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine. Section of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital.Department of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine. Section of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital.Department of Medicine.Department of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine. USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31990709

Citation

Opekun, Antone R., et al. "Routine Disaccharidase Testing: Are We There Yet?" Current Opinion in Gastroenterology, vol. 36, no. 2, 2020, pp. 101-109.
Opekun AR, Chumpitazi BP, Abdulsada MM, et al. Routine disaccharidase testing: are we there yet? Curr Opin Gastroenterol. 2020;36(2):101-109.
Opekun, A. R., Chumpitazi, B. P., Abdulsada, M. M., & Nichols, B. L. (2020). Routine disaccharidase testing: are we there yet? Current Opinion in Gastroenterology, 36(2), 101-109. https://doi.org/10.1097/MOG.0000000000000614
Opekun AR, et al. Routine Disaccharidase Testing: Are We There Yet. Curr Opin Gastroenterol. 2020;36(2):101-109. PubMed PMID: 31990709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Routine disaccharidase testing: are we there yet? AU - Opekun,Antone R,Jr AU - Chumpitazi,Bruno P, AU - Abdulsada,Mustafa M, AU - Nichols,Buford L,Jr PY - 2021/03/01/pmc-release PY - 2020/1/29/entrez PY - 2020/1/29/pubmed PY - 2020/1/29/medline SP - 101 EP - 109 JF - Current opinion in gastroenterology JO - Curr. Opin. Gastroenterol. VL - 36 IS - 2 N2 - PURPOSE OF REVIEW: Disaccharidase testing, as applied to the evaluation of gastrointestinal disturbances is available but it is not routinely considered in the diagnostic work-up. The purpose of this review was to determine if disaccharidase testing is clinically useful and to consider how the results could alter patient management. RECENT FINDINGS: Indicate that carbohydrate maldigestion could contribute functional bowel disorders and negatively impact the fecal microbiome. Diagnostic techniques include enzyme activity assays performed on random endoscopically obtained small intestinal biopsies, immunohistochemistry, stable isotope tracer and nonenriched substrate load breath testing, and genetic testing for mutations. More than 40 sucrase--isomaltase gene variants coding for defective or reduced enzymatic activity have been reported and deficiency conditions are more common than previously thought. SUMMARY: The rationale for disaccharidase activity testing relates to a need to fully assess unexplained recurrent abdominal discomfort and associated symptoms. All disaccharidases share the same basic mechanism of mucosal expression and deficiency has far reaching consequences. Testing for disaccharidase expression appears to have an important role in symptom evaluation, but there are accuracy and logistical issues that should be considered. It is likely that specific recommendations for patient management, dietary modification, and enzyme supplementation would come from better testing methods. SN - 1531-7056 UR - https://www.unboundmedicine.com/medline/citation/31990709/Routine_disaccharidase_testing:_are_we_there_yet L2 - https://doi.org/10.1097/MOG.0000000000000614 DB - PRIME DP - Unbound Medicine ER -
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