Fructose intolerance: An under-recognized problem
Fructose intolerance: An under-recognized problem
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DOI：
10.1111/j.1572-0241.2003.07476.x
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发表时间：
2003-06-01
影响因子：
9.8
通讯作者：
Rao, SSC
中科院分区：
文献类型：
--
作者：
Choi, YK;Johlin, FC;Rao, SSC
目的：虽然乳糖不耐受在腹部症状发病机制中的作用是众所周知的，但果糖不耐受的作用尚不清楚。我们的目的是1）检查不明原因的腹部症状的患者果糖不耐受的患病率，2）探讨果糖浓度是否影响果糖呼吸test.METHODS：超过2年，不明原因的症状的患者回答问卷，并进行果糖呼吸试验。患者接受50 g果糖溶于150 ml水（33%溶液）。采集呼吸样本，以检测氢气和甲烷。在第二项研究中，在给予10%，20%或33%果糖溶液后进行呼吸测试。结果：183例患者（男50例，女133例）进行了呼吸试验，其中134例（73%）为阳性。其中，119例（89%）H-2升高，15例（11%）CH升高，或两种气体均升高。结果显示，最常见的症状是肠胃气胀（83%）、疼痛（80%）、腹胀（78%）、嗳气（70%）和排便习惯改变（65%）。101名患者（75%）的呼吸试验再现了症状。在第二项研究中，14/36例（39%）在10%溶液中检测为阳性，23/33例（70%）在20%溶液中检测为阳性，16/20例（80%）在33%溶液中检测为阳性（10% vs 20%或33%，p < 0.01）。在我们的初步研究中，阳性检测的产量较高可能是由于转诊偏见或检测条件造成的;较低的检测剂量会产生较低的产量。尽管如此，识别和治疗果糖不耐受可能会帮助许多患者。(Am胃肠病学杂志2003;98：1348-1353。(C)2003年，我胃肠病学）。
OBJECTIVES: Although the role of lactose intolerance in the pathogenesis of abdominal symptoms is well known, the role of fructose intolerance is unclear. Our aims were 1) to examine the prevalence of fructose intolerance in patients with unexplained abdominal symptoms, and 2) to explore whether fructose concentration influences fructose breath test.METHODS: Over 2 yr, patients with unexplained symptoms answered questionnaires and underwent fructose breath tests. Patients received 50 g fructose in 150 ml water (33% solution). Breath samples were collected for hydrogen and methane. In a second study, breath test was performed after giving either 10%, 20%, or 33% fructose solution. Data were analyzed retrospectively.RESULTS: A total of 183 patients (50 male, 133 female) had breath tests, of whom 134 (73%) were positive. Among these, 119 (89%) had elevated H-2, and 15 (11%) had elevated CH, or both gases. Questionnaires showed that flatus (83%), pain (80%), bloating (78%), belching (70%), and altered bowel habit (65%) were the most common symptoms. Breath test reproduced symptoms in 101 patients (75%). In the second study, 14/36 (39%) tested positive with a 10% solution, 23/33 (70%) with a 20% solution, and 16/20 (80%) with a 33% solution (10% versus 20% or 33%, p < 0.01).CONCLUSIONS: Fructose intolerance may cause unexplained GI symptoms. The higher yield of positive tests in our initial study may be due to referral bias or testing conditions; lower test dose produced a lower yield. Nonetheless, recognition and treatment of fructose intolerance may help many patients. (Am J Gastroenterol 2003;98:1348-1353. (C) 2003 by Am. Coll. of Gastroenterology).