scholarly journals Lactose intolerance, lactose malabsorption and genetic predisposition to adult-type hypolactasia in patients after restorative proctocolectomy

2019 ◽  
Author(s):  
Jarosław Walkowiak ◽  
Ewa Fidler-Witoń ◽  
Aleksandra Glapa ◽  
Jacek Paszkowski ◽  
Maciej Borejsza-Wysocki ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Genetic Predisposition ◽  
Breath Test ◽  
Lactose Intolerance ◽  
Adenomatous Polyposis ◽  
Adult Type ◽  
Lactose Malabsorption ◽  
Significant Difference ◽  
Lactase Gene

This study provides up-to-date findings on lactose malabsorption, lactose intolerance and genetic predisposition to adult-type hypolactasia in 72 patients after restorative proctocolectomy (RPC). The lactose malabsorption was assessed by hydrogen-methane breath test. Genetic predisposition to adult-type hypolactasia was assessed by detecting –13910T/C polymorphism in the lactase gene. Lactose intolerance was more frequent in UC (ulcerative colitis) patients than FAP (familial adenomatous polyposis) patients (77.5% vs. 55.2%; p=0.01). The C/C genotype of the lactase gene was observed in 39.1% subjects with no significant difference between UC and FAP patients. Lactose malabsorption occurred in 10.1% of subjects and almost only in patients with genetic predisposition, with the same frequency in UC and FAP patients.

scholarly journals A laktózintoleranciáról: Múlt és jelen – I. rész

2015 ◽  
Vol 156 (38) ◽  
pp. 1532-1539
Author(s):  
György Miklós Buzás
Keyword(s):  
Breath Test ◽  
Lactose Intolerance ◽  
Tolerance Test ◽  
Diagnostic Methods ◽  
Chromosome 2 ◽  
Adult Type ◽  
Unequal Distribution ◽  
Bowel Diseases ◽  
Irritable Bowel ◽  
Lactase Gene

Lactose intolerance is the most prevalent intestinal malabsorption disorder. After presentation of its history, the author describes the emergence of lactose intolerance during the evolution of species, and the biochemistry of lactose as well as features of human and bacterial lactase enzymes are then described. The unequal distribution of lactose intolerance in different continents and population is discussed, followed by presentation of past and present prevalence data in Hungary. Adult-type hypolactasia is caused by a polymorphism of the MCM6 gene located upstream from the lactase gene on the long arm of the chromosome 2. It can be determined with the polymerase chain reaction. The intestinal symptoms of lactose intolerance are well known, but its extra-intestinal manifestations are less recognised. Invasive diagnostic methods (determination of lactase activity from small intestinal biopsies, lactose tolerance test), are accurate, but have been replaced by the non-invasive methods; their gold standard is the H2 breath test. Genetic testing is being used more and more frequently in Hungary too, and, presumably, the methane breath test will be also available in the near future. Lactose intolerance can be accompanied by inflammatory bowel diseases, coeliac disease and irritable bowel syndrome; it could be established whether this association is causal or not in order to start a correct diet and therapy. Orv. Hetil., 2015, 156(38), 1532–1539.

scholarly journals Restorative Proctocolectomy: When to Propose and When to Avoid

2021 ◽  
Author(s):  
Marisa D. Santos
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Adenomatous Polyposis ◽  
Entire Colon ◽  
Anal Anastomosis ◽  
Colon And Rectum ◽  
Complex Surgery ◽  
Over Time

Restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA) is a surgical procedure performed when excising the entire colon and rectum is need and reconstitution of the intestinal transit through an ileal pouch is made with anastomosis to the anus. It is mainly used to treat patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC). It is a complex surgery with potential complications, and the functional outcomes can be worse over time. So, it is essential to select the appropriate patient, proceed to a correct surgical technique, and know-how to deal with and solve the main ileal pouch complications. This chapter intends to be a reflection on this subject.

scholarly journals Salvage surgery after restorative proctocolectomy

2004 ◽  
Vol 51 (2) ◽  
pp. 23-26
Author(s):  
R.J. Nicholls
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Salvage Surgery ◽  
Rectal Mucosa ◽  
Neoplastic Transformation ◽  
Mucosal Inflammation ◽  
Adenomatous Polyposis ◽  
Elective Surgical Procedure ◽  
Causes Of Failure

Restorative proctocolectomy is now the elective surgical procedure of choice for most patients with ulcerative colitis or familial adenomatous polyposis. There are four causes of failure including acute and chronic sepsis, poor function for mechanical or functional reasons, mucosal inflammation (including pouchitis and retained rectal mucosa) and neoplastic transformation. Failure rates themselves range from 5% to nearly 20%. Followed over a period of 20 years, the failure rate can be summarised approximately as 5% at five years, 10% at ten years and 15% at 15 years.

scholarly journals Congruency of Genetic Predisposition to Lactase Persistence and Lactose Breath Test

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1383 ◽  
Author(s):  
Enza Coluccia ◽  
Patrizia Iardino ◽  
Diego Pappalardo ◽  
Anna Lisa Brigida ◽  
Vincenzo Formicola ◽  
...  
Keyword(s):  
Breath Test ◽  
Lactose Intolerance ◽  
Genetic Test ◽  
Gastrointestinal Symptoms ◽  
Diagnostic Procedures ◽  
Clinical Syndrome ◽  
Clinical Use ◽  
Genotype C ◽  
Lactase Gene ◽  
Genotype A

The physiological decline of lactase production in adulthood, in some individuals, is responsible for the so-called “Lactose Intolerance.” This clinical syndrome presents with gastrointestinal and non-gastrointestinal symptoms following the consumption of dairy containing food. Lactose intolerance can be evaluated by means of the Lactose Breath Test (phenotype) and/or genetic evaluation of lactase-gene polymorphism (genotype). A comparison of the two tests was carried out in a large number of symptomatic adult subjects, which are selected and not representative of the general population. Congruency was as high as 88.6%. Among lactase non-persistent (genotype C/C), 14 subjects showed a negative Lactose Breath Test (LBT), possibly due to young age. Among lactase-persistent (genotype C/T), four subjects showed a positive LBT, which helps to diagnose secondary lactose intolerance. Symptoms, both gastrointestinal and extra-gastrointestinal, were reported by 90% of patients during the breath test. Clinical use of both tests in the same patients could be taken into consideration as a sharp diagnostic tool. We suggest considering the use of the genetic test after LBT administration, when secondary hypolactasia is suspected, for completion of diagnostic procedures.

Restorative Proctocolectomy in UK Servicemen

2001 ◽  
Vol 87 (3) ◽  
pp. 154-157
Author(s):  
R J Guy ◽  
S Blake ◽  
N P J Cripps
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Service Life ◽  
Restorative Proctocolectomy ◽  
Telephone Interview ◽  
Adenomatous Polyposis ◽  
Royal Navy ◽  
Pouch Function ◽  
Medical Category

AbstractObjectiveTo investigate the outcome of restorative proctocolectomy (RPC) in UK Servicemen and to determine the compatibility of this procedure with Service life.PatientsAll Servicemen undergoing restorative proctocolectomy for ulcerative colitis (UC) or familial adenomatous polyposis (FAP) up to December 31st 2000 were identified from Service records. Patients were reviewed by direct or telephone interview. Pouch function, military duties, medical category or reasons for discharge from the Service were recorded. Results: Fifteen Servicemen (6 Royal Navy, 6 Army, 3 RAF), mean age 30 years, underwent RPC for UC (14) or FAP (1) with a median follow-up of 74 months. Eight remain in their Service, five of whom carry out full duties and three restricted duties. Of the seven who have left the Services only one was medically unfit to continue due to poor pouch function whilst six left voluntarily to pursue active civilian careers. Fourteen patients have acceptable pouch function; one pouch has been excised for intractable pouchitis.ConclusionsRestorative proctocolectomy is compatible with Service life and most individuals are capable of fulfilling active unrestricted military duties.

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