氢呼气文献摘要1.doc

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bowel bacterial overgrowth is not seen in healthy adults but is in disabled older adults Auteur s Author s MITSUI Takahiro 1 SHIMAOKA Kiyoshi 1 GOTO Yumi 2 KAGAMI Hideo 2 KIN OMOTO Hiromasa 2 ITO Akira 2 KONDO Takaharu 1 Affiliation s du ou des auteurs Author s Affiliation s 1 Research Center of Health Physical Fitness and Sports Nagoya University Nagoya JAPON 2 Masuko Memorial Hospital Nakamuraku Nagoya JAPON R sum Abstract Background Aims Small bowel bacterial overgrowth SBBO is defined as an abnormal increase in the number of bacteria in the small intestine and may be occult in older adults The aim of this study was to determine whether small bowel bacterial overgrowth SBBO is found in healthy older people as a concomitant of normal aging or is seen only in disabled or frail older people excluding patients with intestinal disease and those who had undergone upper intestinal or gastric surgery Methodology Forty one relatively healthy older people aged 74 6 1 7 mean SE years who engage in regular exercise and 42 variously disabled older people average age 78 8 1 1 years who commute to a day care center participated in this study SBBO was determined by a breath hydrogen H2 test after ingestion of 50g of glucose solution dissolved in 200mL of water Physical activity was judged from the number of steps walked per day as measured by a pedometer Food intake was assessed by an interview Results No SBBO positive subject was seen among the healthy while 11 25 6 of the disabled older adults were positive The number of steps day taken by the disabled subjects was extremely low only 22 3 of that of the healthy P 0 001 No significant difference was seen between the groups in food intake The mean age of the SBBO positive patients was relatively high 81 5 2 2 years and 5 45 4 of them were underweight with a BMI 18 5 Conclusions Our results and previous studies indicate that SBBO is seen only in patients with intestinal disease and disabled or frail older people Revue Journal Title Hepato gastroenterology ISSN 0172 6390 CODEN HEGAD4 Source Source 2006 vol 53 no67 pp 82 85 4 page s article 17 ref FROM THE AMERICAN ACADEMY OF PEDIATRICS Lactose Intolerance in Infants Children and Adolescents 1 Melvin B Heyman MD MPH 2 for the Committee on Nutrition ABSTRACT The American Academy of Pediatrics Committee on Nutrition presents an updated review of lactose intolerance in infants children and adolescents Differences between primary secondary congenital and developmental lactase deficiency that may result in lactose intolerance are discussed Children with suspected lactose intolerance can be assessed clinically by dietary lactose elimination or by tests including noninvasive hydrogen breath testing or invasive intestinal biopsy determination of lactase and other disaccharidase concentrations Treatment consists of use of lactase treated dairy products or oral lactase supplementation limitation of lactose containing foods or dairy elimination The American Academy of Pediatrics supports use of dairy foods as an important source of calcium for bone mineral health and of other nutrients that facilitate growth in children and adolescents If dairy products are eliminated other dietary sources of calcium or calcium supplements need to be provided Journal of Gastroenterology December 1994 Volume 29 Issue 6 pp 715 720 Milk is a useful test meal for measurement of small bowel transit time Takaharu Kondo Feng Liu Yasushi Toda Abstract To improve and standardize the measurement of small bowel transit time milk was employed for the test meal instead of the conventional lactulose meal Although 92 of the subjects were lactase deficient only 2 were milk intolerant and 13 were lactose intolerant Small bowel transit time with milk milk breath hydrogen test was 113 9 min mean SE n 20 the normal range calculated from the mean 2 SD was 31 195 min The coefficient of variation in the milk hydrogen breath test was 13 4 n 6 whereas in the lactulose hydrogen breath test it was 39 16 n 10 The frequency of non hydrogen producers the occurrence of discomfort and the reproducibility were better though not significantly so in the milk hydrogen breath test than in the lactulose Since lactase activity in the intestine is variable in lactase deficient subjects small bowel transit times for milk may change from subject to subject However individual reproducibility of the milk hydrogen breath test is good It could be useful for pharmacological experiments using paired comparison for screening tests or for the follow up of diseases in which small bowel transit time is affected Evaluation of a triple sugar test of colonic permeability in humans 1 A D G Anderson1 2 P K Jain1 3 S Fleming2 4 P Poon1 5 C J Mitchell1 6 J MacFie1 7 Acta Physiologica Scandinavica 8 Volume 182 Issue 2 pages 171 177 October 2004 9 Abstract 10 Aim Conventional dual sugar tests of intestinal permeability assess only the stomach and small intestine A novel triple sugar method of assessing colonic permeability has recently been described in animals This utilizes the non fermented sweetener sucralose in addition to conventional sugars It has been postulated that this test enables the simultaneous assessment of small intestinal and colonic barrier function in humans The aim of this study was to evaluate the triple sugar test using healthy volunteers and ileostomists 11 Methods Twenty one healthy volunteers and 18 ileostomists underwent the triple sugar test After an overnight fast subjects drank a solution containing lactulose 5 g rhamnose 1 g and sucralose 5 g Urine was collected for 0 5 h and 5 19 h Urinary sugars were quantified using HPLC and 5 and 24 h excretion calculated Nineteen control subjects and 16 ileostomists also underwent a 51Cr EDTA permeability test Permeability data were presented as medians IQR and differences between groups analysed with Mann Whitney U tests 12 Results Lactulose excretion and the 5 h lactulose rhamnose L R ratio were similar in controls and ileostomists L R ratio 0 024 0 022 0 034 vs 0 025 0 022 0 035 P 0 955 Twenty four hours excretion of sucralose was significantly higher in control subjects compared with ileostomists 1 41 1 17 1 68 vs 0 96 0 64 1 2 P 0 003 The same pattern was seen with 51Cr EDTA 2 73 2 06 3 76 vs 2 06 1 55 2 71 P 0 037 and with lactulose 0 52 0 42 0 60 vs 0 25 0 16 0 35 P 0 002 13 Conclusions Both sucralose and 51Cr EDTA underwent significant colonic absorption A significant amount of lactulose also appeared to be absorbed in the colon This unexpected finding requires further study 14 Evaluation of a triple sugar test of colonic permeability in humans 15 Authors 16 Anderson A D G 1 Jain P K 1 Fleming S 2 Poon P 1 Mitchell C J 1 MacFie J 1 17 Source 18 Acta Physiologica Scandinavica Oct2004 Vol 182 Issue 2 p171 177 7p 19 Document Type 20 Article 21 Subject Terms 22 SUGARS VOLUNTEERS SUCRALOSE LACTULOSE COLON Anatomy HIGH performance liquid chromatography 23 Abstract 24 Conventional dual sugar tests of intestinal permeability assess only the stomach and small intestine A novel triple sugar method of assessing colonic permeability has recently been described in animals This utilizes the non fermented sweetener sucralose in addition to conventional sugars It has been postulated that this test enables the simultaneous assessment of small intestinal and colonic barrier function in humans The aim of this study was to evaluate the triple sugar test using healthy volunteers and ileostomists Twenty one healthy volunteers and 18 ileostomists underwent the triple sugar test After an overnight fast subjects drank a solution containing lactulose 5 g rhamnose 1 g and sucralose 5 g Urine was collected for 0 5 h and 5 19 h Urinary sugars were quantified using HPLC and 5 and 24 h excretion calculated Nineteen control subjects and 16 ileostomists also underwent a51Cr EDTA permeability test Permeability data were presented as medians IQR and differences between groups analysed with Mann WhitneyU tests Lactulose excretion and the 5 h lactulose rhamnose L R ratio were similar in controls and ileostomists L R ratio 0 024 0 022 0 034 vs 0 025 0 022 0 035 P 0 955 Twenty four hours excretion of sucralose was significantly higher in control subjects compared with ileostomists 1 41 1 17 1 68 vs 0 96 0 64 1 2 P 0 003 The same pattern was seen with51Cr EDTA 2 73 2 06 3 76 vs 2 06 1 55 2 71 P 0 037 and with lactulose 0 52 0 42 0 60 vs 0 25 0 16 0 35 P 0 002 Both sucralose and51Cr EDTA underwent significant colonic absorption A significant amount of lactulose also appeared to be absorbed in the colon This unexpected finding requires further study ABSTRACT FROM AUTHOR Gut 1996 39 551 555 doi 10 1136 gut 39 4 551 Research Article Intestinal transit in anxiety and depression 1 D A Gorard 2 J E Gomborone 3 G W Libby 4 M J Farthing Author Affiliations 1 Digestive Diseases Research Centre St Bartholomew s London Abstract BACKGROUND Patients with anxiety and depression often have bowel symptoms Until now studies investigating a link between altered bowel habit and psychological illness have focused on patients with disturbed defecation presenting to gastroenterologists AIMS To determine whether patients with anxiety and depression have objective evidence of abnormal intestinal transit irrespective of any bowel symptoms METHODS 21 psychiatric outpatients fulfilling research criteria for generalised anxiety disorder and or major depression and 21 healthy volunteers were studied Orocaecal transit time OCTT was measured by lactulose hydrogen breath test Whole gut transit time WGTT was measured by abdominal radiography after ingestion of radio opaque markers RESULTS Median range WGTT was shorter in patients with anxiety 14 6 29 hours than in patients with depression 49 35 71 hours p 0 001 and controls 42 10 68 hours p 0 001 In patients with anxiety orocaecal transit time was shorter 60 10 70 minutes than in patients with depression 110 60 180 minutes p 0 01 and shorter than in controls 75 50 140 minutes p 0 05 The prolongation of transit times in depression compared with controls was not significant However WGTT correlated with both the Beck Depression Inventory score r 0 59 p 0 01 and the depression score of the Hospital Anxiety and Depression scale r 0 66 p 0 001 CONCLUSIONS These objective measurements of intestinal transit in affective disorders are consistent with clinical impressions that anxiety is associated with increased bowel frequency and depressed patients tend to be constipated mood has an effect on intestinal motor function The American Journal of Gastroenterology 2002 97 2798 2802 doi 10 1111 j 1572 0241 2002 07025 x Short duration exercise increases breath hydrogen excretion after lactulose ingestion description of a new phenomenon Eli D Ehrenpreis MD1 Rajiv S Swamy BS1 Daniel Zaitman MD1 and Imre Noth MD2 1 1Section of Gastroenterology Department of Medicine University of Chicago Chicago Illinois USA 2 2Section of Pulmonary Medicine Department of Medicine University of Chicago Chicago Illinois USA Correspondence Eli D Ehrenpreis MD Associate Professor of Clinical Medicine Section of Gastroenterology University of Chicago 5841 South Maryland Avenue MC 6000 Chicago IL USA 60637 Received 8 April 2002 Accepted 8 July 2002 Topof page Abstract OBJECTIVE There is limited information on the effect of exercise on colonic function Beneficial effects have been described including prevention of colon cancer In the present study we demonstrate that short duration exercise results in enhancement of breath hydrogen excretion after consumption of lactulose METHODS Twelve normal volunteers who performed regular exercise were recruited Each study subject underwent four study sessions two resting and two exercise after consumption of 10 g of crystalline lactulose Colonic hydrogen production was measured in mid expiratory breath samples obtained at baseline and frequent intervals to 420 min Exercise sessions consisted of 5 min on a treadmill at a 20 incline at 10 km h This was performed 180 min after lactulose ingestion in the two exercise sessions RESULTS A characteristic pattern in the hydrogen concentration versustime curves was seen after exercises consisting of an initial decrease then an increase in concentration above baseline for up to 3 h Mean area under the curve from 0 to 420 min for resting studies was 5156 2621 ppm min and was 7051 2447 ppm min for exercise studies p 0 05 37 increase Mean area under the curve from 180 to 420 min was 2808 1592 ppm min for resting studies and 4543 1729 for exercise studies p 0 005 62 increase CONCLUSION This study demonstrates that exercise potentially enhances the metabolism of lactulose by colonic bacteria The authors postulate that this effect is due to stirring of the colonic contents The described phenomenon may explain in part the beneficial effects of exercise on colonic mucosa Journal of Clinical Gastroenterology March 2000 Volume 30 Issue 2 pp 162 169 Clinical Research Effect of Gastric Myoelectric Activity on Carbohydrate Absorption of Fruit Juice in Children Moukarzel A A M D Sabri M T M D Abstract Juices have a different rate of gastric emptying than other foods This may alter the rate of delivery of carbohydrates to the small bowel for absorption The aim of the study is to demonstrate that faster gastric emptying is associated with greater production of hydrogen through a randomized cross over study of 39 healthy children The electrogastrography indicator of the gastric myoelectric activities and breath hydrogen tests indicator of carbohydrate malabsorption were performed at baseline and after ingestion of 240 to 330 mL of grape or pear juice given in a random order The cutaneous electrogastrogram was analyzed by running spectral analysis to compute pre and postprandial period dominant power PDP and running spectrum total power RSTP Postprandial PDP and RSTP were higher p 0 02 in the pear juice group than in the grape juice group suggesting higher antral myoelectric activities Twenty three percent of the subjects had significant movement artifacts that suggested discomfort after drinking pear juice compared to 5 after grape juice p 20 part per million ppm above baseline after pear juice 52 2 mean 36 33 ppm than after grape juice 4 3 6 6 ppm In a multiple regression analysis the most predictive independent variable of hydrogen concentration was found to be either postprandial PDP r2 0 24 p 0 002 or RSTP r2 0 37 p 0 001 Juices affect gastric myoelectric activity Grape juice induces lower antral myoelectric activities and is better absorbed The malabsorption of carbohydrates of juices is in part related to their effect on the gastric physiology Chinese Journal of Microecology 2003 04 Add to Favorite Get Latest Update A PILOT STUDY FOR THE RELATIONSHIP BETWEEN SMALL INTESTINAL BACTERIAL OVERGROWTH AND NON ALCOHOLIC STEATOHEPATITIS HE Ke Jian ZHANG Hou De ZENG Zhong ming et al Division of Gastroenterology Internal Medicine Department Nanshan Hospital Shenzhen 518052 China Objective To investigate the prevalence of small