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. 1971 Feb;12(2):107–109. doi: 10.1136/gut.12.2.107

Disaccharidase levels in the small intestine in patients with diarrhoea following vagotomy and pyloroplasty

J Garcia-Paredes, S C Truelove
PMCID: PMC1411525  PMID: 5548554

Abstract

Diarrhoea is a common sequel to vagotomy and pyloroplasty but its cause is unknown. One of our patients who developed this complication had an abnormal lactose barium meal and responded well to a lactose-free diet. This led us to make a systematic study of disaccharidase activity in the small intestine in patients with diarrhoea following vagotomy and pyloroplasty.

The small-intestinal disaccharidases have been estimated in jejunal biopsy specimens taken from 23 patients suffering from persistent diarrhoea, either continuous or episodic, after vagotomy and pyloroplasty. The disaccharidase values were normal in all but one of these patients. This patient showed hypolactasia but the sucrase and maltase levels were normal. The jejunal biopsy specimen taken from this patient showed a convoluted pattern under the dissecting microscope and severe partial villous atrophy under the light microscope. A repeat jejunal biopsy taken 20 cm beyond the duodeno-jejunal flexure showed similar appearances and also had a low level of lactase. However, two lactose tolerance tests and a lactose barium meal yielded normal results, suggesting that the low level of lactase in the upper jejunum was not a limiting factor in lactose absorption.

The finding of one example of a low lactase level among 23 postvagotomy patients corresponds with what is being found in a study of normal subjects at present in progress.

In effect, almost all patients with persistent diarrhoea after vagotomy and pyloroplasty have normal small-intestinal disaccharidase activity.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BURGESS E. A., LEVIN B., MAHALANABIS D., TONGE R. E. HEREDITARY SUCROSE INTOLERANCE: LEVELS OF SUCRASE ACTIVITY IN JEJUNAL MUCOSA. Arch Dis Child. 1964 Oct;39:431–443. doi: 10.1136/adc.39.207.431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bank S., Barbezat G. O., Marks I. N. Post-gastrectomy steatorrhoea due to intestinal lactase deficiency. S Afr Med J. 1966 Jul 9;40(25):597–599. [PubMed] [Google Scholar]
  3. DAHLQVIST A. METHOD FOR ASSAY OF INTESTINAL DISACCHARIDASES. Anal Biochem. 1964 Jan;7:18–25. doi: 10.1016/0003-2697(64)90115-0. [DOI] [PubMed] [Google Scholar]
  4. Drube H. C., Hansen H. T., Klein U. E., Zielke Z. Disaccharidase activity of the jejunal mucosa in normal subjects and patients after partial gastrectomy. Ger Med Mon. 1967 Sep;12(9):418–421. [PubMed] [Google Scholar]
  5. Gudmand-Hoyer E., Jarnum S., Worning H. Intestinal dissaccharidase activity after Billroth II resection for peptic ulcer. Gut. 1969 Jun;10(6):451–453. doi: 10.1136/gut.10.6.451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Kojecký Z., Matlocha Z. Quantitative differences of intestinal disaccharidase activity following the resection of stomach. Gastroenterologia. 1965;104(6):343–351. doi: 10.1159/000202113. [DOI] [PubMed] [Google Scholar]
  7. Laws J. W., Neale G. Radiological diagnosis of disaccharidase deficiency. Lancet. 1966 Jul 16;2(7455):139–143. doi: 10.1016/s0140-6736(66)92424-x. [DOI] [PubMed] [Google Scholar]
  8. McDonald G. S., Willoughby E., Weir D. G. The incidence of lactase deficiency following partial gastrectomy. Ir J Med Sci. 1969 Oct;8(10):481–488. doi: 10.1007/BF02958620. [DOI] [PubMed] [Google Scholar]
  9. SALEM S. N., SALT R. H., TRUELOVE S. C. CROSBY SMALL-INTESTINAL CAPSULE WITH RADIO-OPAQUE TUBE AND LATEX SHEATH. Gut. 1965 Feb;6:99–100. doi: 10.1136/gut.6.1.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. SOLS A., DE LA FUENTE G. Hexokinase and other enzymes of sugar metabolism in the intestine. Methods Med Res. 1961;9:302–309. [PubMed] [Google Scholar]
  11. Spencer J., Welbourn R. B. Milk intolerance following gastric operations with special reference to lactase deficiency. Br J Surg. 1968 Apr;55(4):261–264. doi: 10.1002/bjs.1800550406. [DOI] [PubMed] [Google Scholar]
  12. Welsh J. D., Shaw R. W., Walker A. Isolated lactase deficiency producing postgastrectomy milk intolerance. Ann Intern Med. 1966 Jun;64(6):1253–1258. doi: 10.7326/0003-4819-64-6-1252. [DOI] [PubMed] [Google Scholar]

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