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Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms.
J Neurogastroenterol Motil. 2020 07 30; 26(3):384-390.JN

Abstract

Background/Aims

Disaccharidase assay is used for assessing carbohydrate intolerance in children, but its usefulness in adults is not known. The aim of this study is to assess the prevalence of disaccharidase deficiency in patients with unexplained gastrointestinal symptoms.

Methods

A retrospective review of adults with chronic (> 1 year) abdominal symptoms and negative imaging and endoscopy/colonoscopy and who completed bowel symptom questionnaire and duodenal biopsy for lactase, maltase, sucrase, and palatinase was performed. A subset also underwent 25 g lactose breath test (LBT).

Results

One hundred twenty patients (females = 83) were evaluated, of whom 48 also underwent LBT. Fifty-six (46.7%) patients had enzyme deficiency; 44 (36.7%) had single (either lactase or maltase), 1 had 3 enzyme deficiencies, 11 (9.2 %) had all 4 disaccharidase enzyme (pan-disaccharidase) deficiency, and 64 (53.0%) had normal enzyme levels. Baseline prevalence and severity of 11 gastrointestinal symptoms were similar between normal and single enzyme deficiency groups. The sensitivity and specificity of LBT was 78.3% and 72.0%, respectively and overall agreement with lactase deficiency was 75.0%.

Conclusions

Isolated disaccharidase deficiency occurs in adults, usually lactase and rarely maltase, and pan-disaccharidase deficiency is rare. Baseline symptoms or its severity did not predict enzyme deficiency.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA, USA.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA, USA.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA, USA.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA, USA.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA, USA.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32380581

Citation

Viswanathan, Lavanya, et al. "Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms." Journal of Neurogastroenterology and Motility, vol. 26, no. 3, 2020, pp. 384-390.
Viswanathan L, Rao SSC, Kennedy K, et al. Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms. J Neurogastroenterol Motil. 2020;26(3):384-390.
Viswanathan, L., Rao, S. S. C., Kennedy, K., Sharma, A., Yan, Y., & Jimenez, E. (2020). Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms. Journal of Neurogastroenterology and Motility, 26(3), 384-390. https://doi.org/10.5056/jnm19167
Viswanathan L, et al. Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms. J Neurogastroenterol Motil. 2020 07 30;26(3):384-390. PubMed PMID: 32380581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms. AU - Viswanathan,Lavanya, AU - Rao,Satish S C, AU - Kennedy,Kevin, AU - Sharma,Amol, AU - Yan,Yun, AU - Jimenez,Enoe, PY - 2019/08/31/received PY - 2020/02/12/revised PY - 2020/02/20/accepted PY - 2020/5/8/pubmed PY - 2020/5/8/medline PY - 2020/5/8/entrez KW - Breath tests KW - Disaccharidase KW - Lactose intolerance KW - Sucrase-isomaltase deficiency SP - 384 EP - 390 JF - Journal of neurogastroenterology and motility JO - J Neurogastroenterol Motil VL - 26 IS - 3 N2 - Background/Aims: Disaccharidase assay is used for assessing carbohydrate intolerance in children, but its usefulness in adults is not known. The aim of this study is to assess the prevalence of disaccharidase deficiency in patients with unexplained gastrointestinal symptoms. Methods: A retrospective review of adults with chronic (> 1 year) abdominal symptoms and negative imaging and endoscopy/colonoscopy and who completed bowel symptom questionnaire and duodenal biopsy for lactase, maltase, sucrase, and palatinase was performed. A subset also underwent 25 g lactose breath test (LBT). Results: One hundred twenty patients (females = 83) were evaluated, of whom 48 also underwent LBT. Fifty-six (46.7%) patients had enzyme deficiency; 44 (36.7%) had single (either lactase or maltase), 1 had 3 enzyme deficiencies, 11 (9.2 %) had all 4 disaccharidase enzyme (pan-disaccharidase) deficiency, and 64 (53.0%) had normal enzyme levels. Baseline prevalence and severity of 11 gastrointestinal symptoms were similar between normal and single enzyme deficiency groups. The sensitivity and specificity of LBT was 78.3% and 72.0%, respectively and overall agreement with lactase deficiency was 75.0%. Conclusions: Isolated disaccharidase deficiency occurs in adults, usually lactase and rarely maltase, and pan-disaccharidase deficiency is rare. Baseline symptoms or its severity did not predict enzyme deficiency. SN - 2093-0879 UR - https://www.unboundmedicine.com/medline/citation/32380581/Prevalence_of_Disaccharidase_Deficiency_in_Adults_With_Unexplained_Gastrointestinal_Symptoms L2 - http://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm19167 DB - PRIME DP - Unbound Medicine ER -
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