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. 2025 Apr 8.
doi: 10.14309/ajg.0000000000003483. Online ahead of print.

Is Carbohydrate Intolerance Associated With Carbohydrate Malabsorption in Disorders of Gut-Brain Interaction?

Hiba Mikhael-Moussa  1 , Charlotte Desprez  1   2 , André Gillibert  3 , Anne-Marie Leroi  1   2 , François Mion  4 , Guillaume Gourcerol  1   2 , Chloé Melchior  1   5
Affiliations

Is Carbohydrate Intolerance Associated With Carbohydrate Malabsorption in Disorders of Gut-Brain Interaction?

Hiba Mikhael-Moussa et al. Am J Gastroenterol. .

Abstract

Introduction: We aimed to explore the prevalence of carbohydrate (lactose and fructose) intolerance in patients with disorders of gut-brain interaction (DGBI) and to characterize those patients regarding gastrointestinal and nongastrointestinal symptoms.

Methods: Patients with DGBI who were referred to the physiology unit of our hospital between May 2022 and December 2023 for lactose (25 g) and fructose (25 g) breath tests were prospectively included. Patients were required to have a negative glucose breath test, before lactose and fructose breath tests, and to have completed the adult carbohydrate perception questionnaire during each breath test. Intolerance was defined as an increase of ≥20 mm in the Visual Analog Scale score from baseline in at least 1 of the 5 symptoms (pain, nausea, bloating, flatulence, and diarrhea) assessed with the adult Carbohydrate Perception Questionnaire.

Results: Among the 301 patients with DGBI included in our analysis, 178 (59.1%) had carbohydrate intolerance. Carbohydrate-intolerant patients were significantly more likely to be female ( P value < 0.001), to have 2 or more DGBI ( P value = 0.001), to have lactose maldigestion ( P value< 0.001) and fructose malabsorption ( P value = 0.023), higher irritable bowel syndrome and somatic symptom severity, and lower quality of life ( P value < 0.001) compared with patients without carbohydrate intolerance. The binary logistic regression showed that lactose maldigestion ( P value = 0.001), as well as somatic symptoms ( P value = 0.025), were independently associated with carbohydrate intolerance (Nagelkerke R Square = 0.206).

Discussion: Carbohydrate intolerance affects a substantial group of patients with DGBI, affecting their quality of life and symptom severity. Further research is needed to explore the underlying mechanisms in patients who do not have carbohydrate malabsorption/maldigestion.

Keywords: adult Carbohydrate Perception Questionnaire; carbohydrate intolerance; disorders of gut-brain interaction; fructose malabsorption; lactose maldigestion.

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References

    1. Böhn L, Störsrud S, Törnblom H, et al. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol 2013;108(5):634–41.
    1. Duncanson KR, Talley NJ, Walker MM, et al. Food and functional dyspepsia: A systematic review. J Hum Nutr Diet 2018;31(3):390–407.
    1. Colomier E, Algera JP, Van Den Houte K, et al. Mechanisms underlying food-related symptoms in disorders of gut-brain interaction: Course ahead in research and clinical practice. Best Pract Res Clin Gastroenterol 2023;62–63:101824.
    1. Hammer HF, Fox MR, Keller J, et al. European guideline on indications, performance, and clinical impact of hydrogen and methane breath tests in adult and pediatric patients: European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Neurogastroenterology and Motility, and European Society for Paediatric Gastroenterology Hepatology and Nutrition consensus. United Eur Gastroenterol J 2022;10(1):15–40.
    1. Misselwitz B, Butter M, Verbeke K, et al. Update on lactose malabsorption and intolerance: Pathogenesis, diagnosis and clinical management. Gut 2019;68(11):2080–91.

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