title: Complex carbohydrate malabsorption in exocrine pancreatic insufficiency.
abstract: The magnitude of complex carbohydrate malabsorption in exocrine pancreatic insufficiency has not been well quantified in the past. The quantity of carbohydrate malabsorbed after a rice starch (100 g) meal in 20 patients with chronic pancreatitis (n = 10) or pancreatic cancer (n = 10) was therefore estimated. Patients had a three day stool fat collection (80 g/24 hour fat intake), a lactulose (20 g), and a rice flour (100 g) breath hydrogen test. Normal controls (n = 29) had a postprandial H2 increase < or = 14 ppm and malabsorbed (mean (SEM)) 1.12 (0.44) (range 0-11.10) g of the 100 g of carbohydrate ingested. Patients malabsorbed significantly more carbohydrate (11.36 (2.23) (range 8.90-32.60) g, F1.47 = 29.92, p < 0.001). The number of patients with fat (> 7 g, n = 8) or carbohydrate (increase in H2 > or = 20 ppm, n = 10) malabsorption was not different (chi 2 = 0.10, p = 0.75). There was a significant correlation between faecal fat and amount of malabsorbed carbohydrate (r = 0.60, F1.17 = 9.70, p = 0.006) and faecal fat and stool wet weight (r = 0.57, F1.18 = 8.67, p < 0.009), but not between stool wet weight and amount of malabsorbed carbohydrate (r = 0.28, F1.17 = 1.45, p = 0.25). Although patients with exocrine pancreatic insufficiency malabsorb 10%-30% of the ingested complex carbohydrate, the main determinant of stool wet weight could be faecal fat.
authors.affiliation: 2nd Department of Internal Medicine-Propaedeutic, University of Athens, Evangelismos Hospital, Greece.
authors.forename: S D
authors.initials: SD
authors.lastname: Ladas
authors.forename: K
authors.initials: K
authors.lastname: Giorgiotis
authors.forename: S A
authors.initials: SA
authors.lastname: Raptis
mesh_terms: D000328:Adult; D000368:Aged; D001944:Breath Tests; D004040:Dietary Carbohydrates / Q000378:metabolism*; D010188:Exocrine Pancreatic Insufficiency / Q000378:metabolism*; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007792:Lactulose; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D012275:Oryza; D010190:Pancreatic Neoplasms / Q000378:metabolism; D010195:Pancreatitis / Q000378:metabolism
chemical_list: D004040:Dietary Carbohydrates; D008055:Lipids; D007792:Lactulose