scholarly journals Tolerance to low-digestible carbohydrates: symptomatology and methods

2001 ◽  
Vol 85 (S1) ◽  
pp. S17-S21 ◽  
Author(s):  
Philippe Marteau ◽  
Bernard Flourié
Keyword(s):  
Small Intestine ◽  
Breath Test ◽  
Absorption Capacity ◽  
Subjective Symptoms ◽  
Intersubject Variability ◽  
Intrasubject Variability ◽  
Hydrogen Breath Test ◽  
Experimental Conditions ◽  
Double Blind ◽  
Double Blind Placebo

Low-digestible carbohydrates (LDCs) are incompletely or not absorbed in the small bowel and fermented in the colon. They are usually well tolerated but may also have some dose-related undesirable effects due to their natural osmotic potential and/or excessive fermentation: borborygmi, excessive flatus, bloating, abdominal cramps and eventually diarrhoea. There is an important intersubject variability in the tolerance to LDCs because of differences in absorption capacity, motility pattern, colonic response and intestinal sensitivity. There is also a great intrasubject variability, depending on the type of LDC, dosage and type of consumption. Absorption of LDC in the small intestine can be assessed using hydrogen breath test or intubation techniques or analysis of ileostomy effluents. Double-blind, placebo-controlled studies are required to assess the subjective symptoms of intolerance, and the experimental conditions may influence the results.

scholarly journals Blinded Oral Challenges with Lactose and Placebo Accurately Diagnose Lactose Intolerance: A Real-Life Study

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1653
Author(s):  
Alba Rocco ◽  
Debora Compare ◽  
Costantino Sgamato ◽  
Alberto Martino ◽  
Luca De Simone ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lactose Intolerance ◽  
Real Life ◽  
Hydrogen Breath Test ◽  
Double Blind ◽  
Lactose Malabsorption ◽  
Double Blind Placebo ◽  
Life Study ◽  
Validated Questionnaire ◽  
Real Life Setting

 Lactose intolerance (LI) is characterized by diarrhea, abdominal pain, or bloating occurring after lactose consumption in patients with lactose malabsorption. The National Institute of Health (NIH) proposed a double-blind placebo testing to identify LI individuals correctly. However, until now, no study used this approach in a real-life setting. We aimed to assess double-blind placebo challenge accuracy in diagnosing LI in patients with self-reported symptoms of LI. 148 patients with self-reported LI were consecutively enrolled and blindly underwent hydrogen breath test (HBT) after 25 g lactose or 1 g glucose (placebo) load. One week later, the subjects were challenged with the alternative substrate. Each subject completed a validated questionnaire, including five symptoms (diarrhea, abdominal pain, vomiting, bowel sounds, and bloating) scored on a 10-cm visual analog scale. Home questionnaire (HQ) referred to symptoms associated with the consumption of dairy products at home, while lactose questionnaire (LQ) and placebo questionnaire (PQ) referred to symptoms perceived throughout the 4-h after the administration of the substrates, respectively. After lactose load, HBT was positive in 81 patients (55%), of whom 60 (74%) reported relevant symptoms at LQ (lactose malabsorbers, LM). After placebo challenge, 45 out of 60 with a positive lactose challenge did not complain of symptoms and therefore were diagnosed as lactose intolerant, according to NIH definition. The blinded oral challenges with lactose and placebo accurately diagnose LI and identify patients who will likely benefit from a lactose-free diet. 

Interpretation of subjective symptoms in double-blind placebo-controlled food challenges - interobserver reliability

Allergy ◽  
2004 ◽  
Vol 59 (3) ◽  
pp. 354-356 ◽  
Author(s):  
M. Gellerstedt ◽  
J. Magnusson ◽  
U. Grajo ◽  
S. Ahlstedt ◽  
U. Bengtsson
Keyword(s):  
Interobserver Reliability ◽  
Subjective Symptoms ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Food Challenges

Efficacy and Tolerability of Oral Acetylcysteine (Fabrol®) in Chronic Bronchitis: A Double-Blind Placebo Controlled Study

1984 ◽  
Vol 12 (3) ◽  
pp. 198-206 ◽  
Author(s):  
I M Jackson ◽  
Janice Barnes ◽  
P Cooksey
Keyword(s):  
Chronic Bronchitis ◽  
Controlled Study ◽  
Subjective Symptoms ◽  
Trial Period ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Patient Study ◽  
Treatment Groups ◽  
The United Kingdom ◽  
Placebo Trial

This multicentre, double-blind, placebo controlled, between-patient study in general practice in the United Kingdom examined the effect of oral N-acetylcysteine (Fabrol®) on the symptomatology of patients with chronic bronchitis over a 3-month period. Although improvement in subjective symptoms (sputum viscosity and character, difficulty in expectoration and cough severity) occurred in both treatment groups over the trial period, improvements in difficulty in expectoration and cough severity were greater in patients receiving N-acetylcysteine compared to matching placebo. Trial medication was well tolerated, with a greater number of side-effects attributed to therapy occurring inpatients receiving placebo.

Treatment of Small Intestine Bacterial Overgrowth with Rifaximin, a Non-Absorbable Rifamycin

1988 ◽  
Vol 16 (4) ◽  
pp. 312-316 ◽  
Author(s):  
G. R. Corazza ◽  
M. Ventrucci ◽  
A. Strocchi ◽  
M. Sorge ◽  
L. Pranzo ◽  
...  
Keyword(s):  
Small Intestine ◽  
Side Effects ◽  
Small Bowel ◽  
Therapeutic Efficacy ◽  
Breath Test ◽  
Bacterial Overgrowth ◽  
Hydrogen Breath Test ◽  
Small Bowel Bacterial Overgrowth ◽  
Small Intestine Bacterial Overgrowth ◽  
Lactulose Hydrogen Breath Test

In twelve patients affected by small bowel bacterial overgrowth, diagnosed by means of the lactulose hydrogen breath test, the therapeutic efficacy of a non-absorbable derivative of rifamycin, rifaximin, was evaluated. This study showed that this drug has a satisfactory therapeutic efficacy in contaminated small bowel syndrome and, at the doses tested, is free of side-effects.

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