Investigations for cho malabsorption


:black_circle:Measurement of CHO in the stool, using a Clinitest reagent to identifie reducing substances, is a simple screening test.:heavy_check_mark::eyes:

:black_circle: An acidic stool with >2+ reducing substance suggests carbohydrate malabsorption.:ok_hand::poop:
:black_circle: Sucrose or starch in the stool is not recognized as a reducing sugar until after hydrolysis with hydrochloric acid, which converts them to reducing sugars.:bangbang::+1:
:black_circle:Breath hydrogen test is used to identify the specific CHO that is malabsorbed . :speaking_head::speaking_head:
:fast_forward:After an overnight fast, the suspected sugar (lactose, sucrose, fructose, or glucose) is administered as an orally (CHO load 1-2 g/kg, maximum 50 g). :ok_hand::zipper_mouth_face:
:fast_forward:In malabsorption,the sugar is not digested or absorbed in the small bowel, passes on to the colon, and is metabolized by the normal bacteria flora.:zipper_mouth_face: :no_mouth:
:fast_forward:One of the products of this process is hydrogen gas, which is absorbed through
the colon mucosa and excreted in the breath.:speaking_head::poop:
:fast_forward: :arrow_up: hydrogen conc in the breath samples suggests CHO malabsorption. :chart_with_upwards_trend:
:fast_forward::arrow_up:breath hydrogen of 20 ppm above the baseline is considered +ve test :white_check_mark::white_check_mark:
:fast_forward: The child should not be on antibiotics at the time of the test, because colonic flora is essential for fermenting the sugar.:poop::lollipop:
:black_circle:Small bowel mucosal biopsies can measure mucosal disaccharidase
(lactase, sucrase, maltase, palatinase) concentrations directly.:+1::bangbang:
:fast_forward: In 1ry enzyme deficiencies the mucosal enzyme levels are low and small bowel mucosal morphology is normal. :heavy_check_mark::heavy_check_mark:
:black_circle:Partial or total villous atrophy due to disorders such as celiac disease, or following rotavirus gastroenteritis can result in secondary disaccharidase deficiency and
transient lactose intolerance. The disaccharidase levels revert to normal after mucosal healing