Morty Yalovsky

Fructose and Sorbitol Malabsorption in Ambulatory Patients with Functional Dyspepsia Comparison with Lactose Maldigestion/Malabsorption

The aim of this study was to study sugarmaldigestion/malabsorption in patients with functionaldyspepsia using H breath testing. End-expiratory breathH after separate 2 challenges with lactose (25 g), fructose (25 g), and sorbitol (5 g) were usedto determine malabsorption, as well as small boweltransit time (SBTT). Five hundred twenty patients withfunctional dyspepsia received all three challenges. Smaller groups were also tested after lactulose(10 g, N = 36) and glucose (50 g, N = 90) challenges.Fructose and sorbitol were closely linked with respectto absorption and malabsorption status. Only in the case of lactose maldigestion/malabsorption wasthere a greater than random prevalence of malabsorption(P < 0.001) for fructose and sorbitol. In contrast tolactose, ethnic origin did not influence fructose or sorbitol malabsorption, and femalespredominated among fructose and sorbitol malabsorbers.In Jews, the prevalence of lactosemaldigestion/malabsorption decreased in the age group of25-55 and subsequently rose after 55, while fructose and sorbitolmalabsorption decreased progressively with advancingage. With respect to small bowel transit time (SBTT), inthe case of sorbitol and lactulose, it was significantly greater (P < 0.05) than those for fructoseand lactose. Multiple sugar malabsorptions are commonwhen lactose maldigestion/malabsorption ispresent.

The glucose breath test: A diagnostic test for small bowel stricture(s) in Crohn's disease

The aim of this study was to determine whether an indirect noninvasive indicator of proximal bacterial overgrowth, the glucose breath test, was of diagnostic value in inflammatory bowel disease. Twenty four of 71 Crohns disease patients tested had a positive glucose breath test. No statistical conclusions could be drawn between the Crohns disease activity index and glucose breath test status. Of patients with radiologic evidence of small bowel stricture(s), 96.0% had a positive glucose breath test, while only one of 46 negative glucose breath test patients had a stricture. The positive and negative predictive values for a positive glucose breath test as an indicator of stricture formation were 96.0% and 97.8%, respectively. This correlation was not altered in Crohns disease patients with fistulae or status postresection of the terminal ileum. The data in ulcerative colitis were nondiagnostic. In conclusion, the glucose breath test appears to be an accurate noninvasive inexpensive diagnostic test for small bowel stricture(s) and secondary bacterial overgrowth in Crohns disease.

The in vitro uptake and kinetics of release of palmitic acid and taurodeoxycholate from hamster small intestinal segments.

Abstract 1. 1. Everted sacs from hamster proximal and distal small intestine were incubated for 10 min at 37° in a micellar solution containing labeled palmitic acid, sodium taurodeoxycholate and inulin. After incubation, efflux of the labeled compounds from the intestinal mucosa was measured by sequential 1-min rinsings in separate 20-ml volume of ice-cold Krebs-Ringer phosphate buffer for a total of 25 min. The radio-activity in each rinsing solution, tissue homogenates and serosal fluids was assayed. 2. 2. The uptake of labeled taurodeoxycholate and inulin by the proximal and distal small intestine was not significantly different. However, the amount of [I- 14 C] palmitic acid taken up by the proximal small intestine was significantly greater. 3. 3. A considerable fraction of the labeled substances taken up during the initial incubation could be released by rinsing. The distal small intestine released a greater fraction of labeled palmitic acid and its release appeared to be inversely related to the esterifying capacity of the intestine. Proportionately greater amounts of [ 3 H] taurodeoxycholate and [ 14 C]inulin than that of [1- 14 C]palmitic acid were released by both proximal and distal small intestine. 4. 4. Analysis of the kinetics of efflux of each substance indicated that efflux occurred from two compartments, one rapidly and one slowly turning over. The characteristics of efflux of labeled palmitic acid and taurodeoxycholate from the rapidly turning over compartment were similar to those of labeled inulin suggesting that they occupied the extracellular fluid space. The characteristics of efflux from the slowly turning over compartment were different for each substance, and no conclusions could be drawn regarding the location of this compartment. However, the finding that the efflux of [1- 14 C]palmitic acid and [ 3 H]taurodeoxycholate from this compartment was slower than that of [ 14 C]inulin indicate that superticial binding sites may be involved in the reversible uptake of these substances. In addition the ratio of [ 3 H]taurodeoxycholate to [1- 124 C]palmitic acid in this compartment was greatly in excess of the 10:1 ratio of the micellar incubation medium indicating that the efflux of [ 3 H]taurodeoxycholate exceeded that of [1- 14 C]palmitic acid.

Identifying malignant and pre-malignant lesions in average-risk individuals of a predominantly African American and hispanic population in the Bronx, New York

Identifying malignant and pre-malignant lesions in average-risk individuals of a predominantly African American and hispanic population in the Bronx, New York