What Is Carbohydrate Malabsorption? Carbohydrate malabsorption is a digestive disorder characterized by the inability to properly digest and absorb carbohydrates within the small intestine to supply needed energy to the body. Q: What carbohydrates should be normally…
What Is Lactose Intolerance?Lactose intolerance is a well known symptom of carbohydrate malabsorption characterized by inability to properly digest lactose, the sugar in milk, due to low lactase digesting activity in the small intestine.
Lactase is an enzyme produced by specialized cells in the tips of villi within the brush border of the small intestinal lining that digests lactose.
Lactose is a disaccharide, or double sugar, made up of a molecule of glucose and a molecule of galactose (simple sugars). Lactose cannot be absorbed as is into the body unless it is broken down by lactase into glucose and galactose.
Q: How does lactose cause diarrhea?
A: If lactose is not broken down, undigested lactose moves into the colon where it acts osmotically to draw water from the walls of the colon into the lumen, which causes diarrhea by the unnatural amount of water. How much water? Can be 2 liters! Meanwhile, the normal population of colonic bacteria ferment the undigested lactose, generating short-chain fatty acids and hydrogen gas, resulting in bloating pain and flatulence.
Testing for intolerance is based on the action of lactose to increase intestinal permeability.1 Positive response to a breath hydrogen test (BHT), involving 1 – 3 hours of time post ingestion of lactose test dose, signifies malabsorption in the small intestine and fermentation in the colon. If BHT is positive before 60 minutes, the result implies bacteria is abnormally present in the small intestine, causing fermentation there.
Endoscopy is used to measure activity of lactase in a tissue sample.
Treatment is avoidance of milk and dairy products that contain lactose. Nevertheless, milk treated with lactase enzyme can be safely consumed. Fermented milk products like yogurt or kefir are safe because the lactose has been digested by organisms. If there is also a problem with milk protein, then no milk is acceptable that comes from the cow or animal that is causing the allergy.
Maltose intolerance is an enzymopathy (enzyme failure) characterized by inability of the gut to properly break down maltose sugar molecules in food due to low maltase enzyme activity of the small intestinal lining.
Q: What is maltose and maltase?
A: Maltose is a double sugar made up of two molecules of glucose and is derived from starch. Maltase is the enzyme required to digest or release glucose from maltose. Maltase is produced in the microscopic brush border (microvilli) at the base of villi.
Here’s what happens when maltose is not digested:
Inability to digest maltose sugar in starch due to low maltase enzyme activity in the small intestinal lining. Undigested maltose causes diarrhea by osmotically to draw water into the intestine. Click for full description.
An acute and sometimes fatal disease caused by rapid loss of potassium through diarrhea and vomiting.
The level of magnesium in the bloodstream is too low to meet metabolic needs of the body for this mineral.
The level of phosphorus in the bloodstream is too low to meet metabolic needs of the body for this mineral.
I just received an email from the Celiac Disease Research Center at Columbia University regarding a study showing a possible association between a blood pressure medication and villous atrophy. The blood pressure medication is called olmesartan and it is also known as Benicar, Benicar HCT, Azor, and Olmetec.
According to this article, the three-year study was conducted by the Mayo Clinic in Rochester, Minnesota and it included 22 patients who had symptoms of celiac disease, but antibody blood tests did not support that diagnosis. During this study patients improved with discontinuation of the drug, while a gluten-free diet had had no impact on their
