Isolated Lactase Deficiency Producing Postgastrectomy Milk Intolerance

Abstract

Article1 June 1966Isolated Lactase Deficiency Producing Postgastrectomy Milk IntoleranceJACK D. WELSH, M.D., ROBERT W. SHAW, B.S., ANTHONY WALKER, B.S.JACK D. WELSH, M.D., ROBERT W. SHAW, B.S., ANTHONY WALKER, B.S.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-6-1252 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe ingestion of milk and milk products may precipitate postprandial symptoms in some patients after gastric surgery for peptic ulcer disease (1). Milk allergy (2), location of the gastrojejunal anastomosis (3), and intestinal lactase deficiency (4) have been suggested as possible causes. Two patients whose postgastrectomy symptoms were associated with an isolated lactase deficiency were subjects of an earlier report (5). The present investigation expands these observations and evaluates lactose tolerance tests and the intestinal disaccharidase activity in a group of 24 patients who underwent gastric surgery.MATERIAL AND METHODSPATIENTSOut of all the subjects, 19 males and 5...References1. GAVISER D: Clinical investigation and evaluation of four hundred sixteen cases consecutively operated upon for peptic ulcer. Surgery 24: 873, 1948. MedlineGoogle Scholar2. HELLEMANS N: The so-called "dumping syndrome" after partial gastric resection for peptic-ulcer. Acta Med. Scand. 148: 367, 1954. CrossrefMedlineGoogle Scholar3. GRYBOSKITHAYERGRYBOSKIGABRIELSONSPIRO JDWRWAIWHM: A defect in disaccharide metabolism after gastrojejunostomy. New Eng. J. Med. 268: 78, 1963. CrossrefMedlineGoogle Scholar4. AURICCHIORUBINOLANDOLTSEMENZAPRADER SAMGA: Isolated intestinal lactase deficiency in the adult. Lancet 2: 324, 1963. CrossrefMedlineGoogle Scholar5. WELSHROHRERDREWRYMAYWALKER JDGVRJCA: Human intestinal disaccharidase activity. II. Diseases of the small intestine and deficiency states. Arch. Intern. Med. (Chicago) 117: 495, 1966. CrossrefMedlineGoogle Scholar6. NELSON N: A photometric adaptation of the Somogyi method for the determination of glucose. J. Biol. Chem. 153: 375, 1944. CrossrefGoogle Scholar7. BICKEL H: Mellituria, a paper chromatographic study. J. Pediat. 59: 641, 1961. CrossrefMedlineGoogle Scholar8. CHRISTIANSENKIRSNERABLAZA PAJBJ: D-xylose and its use in the diagnosis of malabsorptive states. Amer. J. Med. 27: 443, 1959. CrossrefMedlineGoogle Scholar9. VAN DE KAMERTEN BOKKEL HUININKWEYERS JHHHA: Rapid method for the determination of fat in feces. J. Biol. Chem. 177: 347, 1949. CrossrefMedlineGoogle Scholar10. BAKERHUGHES SJA: Multiple-retrieving small-intestinal biopsy tube. Lancet 2: 686, 1960. CrossrefMedlineGoogle Scholar11. WELSHROHRERPORTER JDGVMG: Baker-Hughes gastrointestinal biopsy tube. Amer. J. Dig. Dis. In press. Google Scholar12. MADANAGOPALANSHINERROWE NMB: Measurements of small intestinal mucosa obtained by peroral biopsy. Amer. J. Med. 38: 42, 1965. CrossrefMedlineGoogle Scholar13. DAHLQVIST A: Method for assay of intestinal disaccharidases. Anal. Biochem. 7: 18, 1964. CrossrefMedlineGoogle Scholar14. KLEINREADBABSON BPAAL: Rapid method for the quantitative determination of serum alkaline phosphatase. Clin. Chem. 6: 269, 1960. CrossrefMedlineGoogle Scholar15. LOWRYROSEBROUGHFARRRANDALL OHNJALRJ: Protein measurement with the Folin phenol reagent. J. Biol. Chem. 193: 265, 1951. CrossrefMedlineGoogle Scholar16. WELSHROHRERWALKER JDGVA: Human intestinal disaccharidase activity. I. Normal individuals. Arch. Intern. Med. (Chicago) 117: 488, 1966. CrossrefMedlineGoogle Scholar17. MCMICHAELWEBBDAWSON HBJAM: Lactase deficiency in adults. Lancet 1: 717, 1965. CrossrefMedlineGoogle Scholar18. DUNPHYLITTMANHAMMONDFORSTNERDAHLQVISTCRANE JVAJBGARK: Intestinal lactase deficiency in adults. Gastroenterology 49: 12, 1965. CrossrefGoogle Scholar19. JEEJEEBHOYDESAIVERGHESE KNHGRV: Milk intolerance in tropical malabsorption syndrome. Lancet 2: 666, 1964. CrossrefMedlineGoogle Scholar20. PETERNEL WW: Lactose tolerance in relation to intestinal lactase activity. Gastroenterology 48: 299, 1965. CrossrefMedlineGoogle Scholar21. CUATRECASASLOCKWOODCALDWELL PDHJR: Lactase deficiency in the adult. Lancet 1: 14, 1965. CrossrefMedlineGoogle Scholar22. HAEMMERLIKISTLERAMMANNMARTHALERSEMENZAAURICCHIOPRADER UPHRTGSA: Acquired milk intolerance in the adult caused by lactose malabsorption due to a selective deficiency of intestinal lactase activity. Amer. J. Med. 38: 7, 1965. CrossrefMedlineGoogle Scholar23. STAMMERSWILLIAMS FAJA: Partial Gastrectomy. Butterworth & Co. (Publishers) Ltd., London, 1963. Google Scholar24. SEWELLCOOKECOXMEYNELL PWTEVMJ: Milk intolerance in gastrointestinal disorders. Lancet 2: 1132, 1963. CrossrefMedlineGoogle Scholar25. WEIDNERSCOTTBONDSHULL MGHWAGHJ: The dumping syndrome. I. Studies in patients after gastric surgery. Gastroenterology 37: 188, 1959. CrossrefMedlineGoogle Scholar26. MORRISGREENFIELDJORDANPEDDIEGORDONDEBAKEY GCLJGLGHJRME: Physiologic considerations in the dumping syndrome. Ann. Surg. 150: 90, 1959. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JACK D. WELSH, M.D.; ROBERT W. SHAW, B.S.; ANTHONY WALKER, B.S.Affiliations: Oklahoma City, OklahomaFrom the Department of Medicine, the University of Oklahoma Medical Center, Oklahoma City, Okla.This study was supported in part by training grant TI AM 5179-06 from the National Institutes of Health, Bethesda, Md.This study was presented in part at a meeting of the Midwestern Section of the American Federation for Clinical Research, Chicago, Ill., November 4, 1965.Requests for reprints should be addressed to Jack D. Welsh, M.D., Department of Medicine, University of Oklahoma Medical Center, 800 NE 13th St., Oklahoma City, Okla. 73104. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCarbohydrate Digestion: Development in Early InfancyCarbohydrates in pediatric nutrition and gastrointestinal diseaseCarbohydrates in Pediatric Nutrition—Consumption, Digestibility, and DiseaseEffect of pancreatic proteases on intestinal lactase activityAdequacy of endoscopic biopsy specimens for disaccharidase assaysSUGARSIgA DEFICIENCY AND SEVERE POST-VAGOTOMY DIARRHŒASmall Intestinal Disaccharidase DeficienciesDisaccharidase levels in the small intestine in patients with diarrhoea following vagotomy and pyloroplastyClose Relationship between Lactose Intolerance and Allergy to Milk ProteinDisaccharidase DeficiencyLactose Malabsorption in Patients Operated Upon for Peptic UlcerThe incidence of lactase deficiency following partial gastrectomyMalabsorptionMilk Intolerance Following Gastric SurgerySUGARSRecovery of villous architecture in gluten enteropathy exacerbated by gastro-jejunal anastomosisCommentaryOn the Lactose Tolerance Test 1 June 1966Volume 64, Issue 6Page: 1252-1258KeywordsExcretionGastroenterology and hepatologyIngestionLactoseMilkPeptic ulcersPhosphatasesPostgastrectomyProteinsSurgery ePublished: 1 December 2008 Issue Published: 1 June 1966 PDF downloadLoading ...