Transient Carbohydrate Malabsorption and Intolerance in Diarrheal Diseases of Infancy
نویسنده
چکیده
Carbohydrate intolerance has been shown to be common during and immediately following an episode of diarrhea, particularly in infancy and childhood. When these infants and children are maintained on diets with high concentrations of a specific carbohydrate or class of carbohydrates, the symptoms will continue and often increase in severity. On removal of the carbohydrate(s) from their diet for a relatively short period, the infants recover; most infants so affected will have no return of carbohydrate intolerance even on long-term follow-up. Transient carbohydrate intolerance, in conjunction with chronic malabsorption, was recognized in the early 1920s. In the subsequent decades, studies of carbohydrate intolerance have revealed a common mechanism, i.e., disaccharidase deficiency. However, congenital absence of disaccharidases has been shown to represent only a small percentage of the infants suffering from chronic diarrhea. It was not until the 1960s that Weijers (1) proposed the hypothesis of secondary disaccharidase deficiency as the underlying mechanism for the majority of the carbohydrate intolerance associated with persistent diarrhea. As the name implies, the disaccharidase deficiency is initiated and sustained by any process that damages the mature enterocytes. This entity has been called by various names, including temporary, secondary, or acquired carbohydrate intolerance. All refer to conditions that injure the small intestinal mucosa, resulting in carbohydrate maldigestion and malabsorption manifest by carbohydrate intolerance. This chapter will concentrate on this entity, with carbohydrate malabsorption associated with specific diarrheas mentioned only briefly.
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تاریخ انتشار 2006