A retrospective study on the association of gastrointestinal symptoms in children with low lactase activity and low activity of other disaccharidases

Disaccharidase deficiencies and gastrointestinal symptoms in patients referred to gastroscopic examination: a single center study from Norway

OBJECTIVE

Gastrointestinal illnesses have been reported in relation to low disaccharidase activity, yet both the prevalence of disaccharidase deficiency and its association with gastrointestinal symptoms and irritable bowel syndrome (IBS) are largely unknown. We aimed to determine the association between low activity of disaccharidase enzymes on gastrointestinal symptoms and presence of IBS.

METHODS

Patients referred for gastroscopic examination due to gastrointestinal complaints were consecutively included. A pinch biopsy was taken from the distal part of duodenum, and disaccharidase activity was measured using the Dahlqvist method. Gastrointestinal symptom severity was measured using IBS-Symptom Severity Score (IBS-SSS).

RESULTS

A total of 40 patients were included. Disaccharidase deficiency was detected in 24 patients (60%). Half of the patients (n = 21) had IBS according to Rome IV criteria. A majority (75%) of all patients reported moderate to severe gastrointestinal symptoms. Moderate to severe gastrointestinal symptoms were reported by 16 patients (67%) with disaccharidase deficiency and in 14 patients (88%) with normal disaccharidase activity. Lactase deficiency was detected in 22 patients (55%), maltase deficiency in 11 patients (28%), sucrase deficiency in 9 patients (23%), isomaltase deficiency in 13 patients (33%) and glucoamylase deficiency in 12 patients (30%). The activity of all enzymes was reduced in 8 patients (20%). Degree of disaccharidase deficiency was not associated with either the severity of gastrointestinal symptoms or the diagnosis of IBS. Enzymes levels were not associated with gastrointestinal symptom scores.

CONCLUSION

Our findings did not reveal any association between biochemically measured disaccharidase deficiency and gastrointestinal symptoms or the presence of IBS.

Sources, Processing-Related Transformation, and Gut Axis Regulation of Conventional and Potential Prebiotics

One strategy to achieve a balanced intestinal microbiota is to introduce prebiotics. Some substances present in the diet, such as soybean extracts, koji glycosylceramides, grape extracts, tea polyphenols, and seaweed extracts, can be considered as potential prebiotics, because they can selectively stimulate the proliferation of beneficial bacteria in the intestine. However, the discovery of novel prebiotics also involves advances in screening methods and the use of thermal and non-thermal processing techniques to modify and enhance the properties of beneficial organisms. The health benefits of prebiotics are also reflected by their participation in regulating the microbiota in different gut axes. In the present review, we introduced the field of prebiotics, focusing on potential prebiotic substances, the process of screening potential prebiotics, the transformation of prebiotics by food-processing technologies, and the roles of prebiotics on gut axis regulation, which, it is hoped, will promote the discovery and utilization of novel prebiotics.