A Prospective Multicenter Study on the Prevalence of Fructose Malabsorption in Patients with Chronic Inflammatory Bowel Disease.


Journal

Digestion
ISSN: 1421-9867
Titre abrégé: Digestion
Pays: Switzerland
ID NLM: 0150472

Informations de publication

Date de publication:
2021
Historique:
received: 30 09 2019
accepted: 12 04 2020
pubmed: 10 6 2020
medline: 19 8 2021
entrez: 10 6 2020
Statut: ppublish

Résumé

Patients with chronic inflammatory bowel disease (IBD) might have a higher prevalence of fructose malabsorption than healthy controls. This study's aim was to determine the prevalence and symptom severity of fructose malabsorption in patients with active and inactive IBD. The present study was a multicenter noninterventional diagnostic pilot trial. Two hundred fifty-one participants were recruited from 12 outpatient clinics for internal medicine across Germany and from the University of Kiel. Fructose malabsorption was diagnosed by hydrogen breath testing. Patients diagnosed with bacterial overgrowth, non-H2 producers, and patients who were tested positive for lactose malabsorption were excluded. Gastrointestinal symptoms during breath testing were evaluated using four-point subjective items to determine severity of bloating, abdominal pain, and diarrhea. Two hundred five patients (45 with active IBD, 80 with IBD in remission, and 81 healthy controls) were analyzed. The number of patients diagnosed with fructose malabsorption - 35/44 (79.6%) in patients with active IBD, 59/80 (73.8%) inactive IBD, and 66/81 (81.5%) in healthy controls - did not differ between the groups (χ2 [2, N = 205] = 1.48, p = 0.48). However, abdominal pain was more frequent in patients with active IBD than patients with IBD in remission (z = -2.936, p = 0.010), and diarrhea was more frequent in patients with active IBD than in healthy controls (z = 2.489, p = 0.038). Fructose malabsorption is not more common among patients with IBD than healthy subjects. However, the greater prevalence of patient-reported symptoms among patients with IBD may be of pathological and therapeutic relevance.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Patients with chronic inflammatory bowel disease (IBD) might have a higher prevalence of fructose malabsorption than healthy controls. This study's aim was to determine the prevalence and symptom severity of fructose malabsorption in patients with active and inactive IBD.
METHODS METHODS
The present study was a multicenter noninterventional diagnostic pilot trial. Two hundred fifty-one participants were recruited from 12 outpatient clinics for internal medicine across Germany and from the University of Kiel. Fructose malabsorption was diagnosed by hydrogen breath testing. Patients diagnosed with bacterial overgrowth, non-H2 producers, and patients who were tested positive for lactose malabsorption were excluded. Gastrointestinal symptoms during breath testing were evaluated using four-point subjective items to determine severity of bloating, abdominal pain, and diarrhea.
RESULTS RESULTS
Two hundred five patients (45 with active IBD, 80 with IBD in remission, and 81 healthy controls) were analyzed. The number of patients diagnosed with fructose malabsorption - 35/44 (79.6%) in patients with active IBD, 59/80 (73.8%) inactive IBD, and 66/81 (81.5%) in healthy controls - did not differ between the groups (χ2 [2, N = 205] = 1.48, p = 0.48). However, abdominal pain was more frequent in patients with active IBD than patients with IBD in remission (z = -2.936, p = 0.010), and diarrhea was more frequent in patients with active IBD than in healthy controls (z = 2.489, p = 0.038).
CONCLUSIONS CONCLUSIONS
Fructose malabsorption is not more common among patients with IBD than healthy subjects. However, the greater prevalence of patient-reported symptoms among patients with IBD may be of pathological and therapeutic relevance.

Identifiants

pubmed: 32516791
pii: 000507851
doi: 10.1159/000507851
doi:

Substances chimiques

Fructose 30237-26-4
Hydrogen 7YNJ3PO35Z

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

397-403

Informations de copyright

© 2020 S. Karger AG, Basel.

Auteurs

Ulf Helwig (U)

Medical Practice for Internal Medicine Oldenburg, Oldenburg, Germany, helwig@internisten-ol.de.
Department of Internal Medicine, Christian-Albrechts University of Kiel, Kiel, Germany, helwig@internisten-ol.de.

Anna K Koch (AK)

Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany.

Christoph Reichel (C)

Rehabilitation Center Bad Brückenau, Clinic Hartwald, Bad Brückenau, Germany.
Institute of Hygiene and Public Health, Bad Brückenau, Germany.

Petra Jessen (P)

Medical Practice for Internal Medicine, Kiel, Germany.

Jürgen Büning (J)

Medical Practice for Gastroenterology Lübeck, Lübeck, Germany.

Stefan Schreiber (S)

Department of Internal Medicine, Christian-Albrechts University of Kiel, Kiel, Germany.

Jost Langhorst (J)

Department of Internal and Integrative Medicine, Klinikum Bamberg, Bamberg, Germany.
Chair for Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.

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Classifications MeSH