By means of isotope 47Ca, changes in the rate and intensity of calcium absorption from lactose-free milk and normal milk were investigated as well as 47Ca losses in faeces and urine and Ca retention in the organism during a 7-day period in healthy volunteers and in patients with lactose intolerance. The shape of 47Ca absorption curves after lactose-free milk in healthy subjects is lower than after milk with a normal lactose content. Conversely, in subjects with lactose intolerance, the shape of the absorption curves of 47Ca was lower after ingestion of normal milk and higher after ingestion of lactose-free milk. The total amount of absorbed and retained Ca practically does not differ, regardless whether Ca was administered in milk or lactose-free milk. No significant differences were found in the utilization of Ca in subjects with lactose intolerance. In these patients, the retardation of the peaks of the absorption curves after ingestion of milk most probably suggests a compensatory delay of gastric evacuation. The slower supply of chyme into the gut improves the utilization of Ca in spite of relative lactase insufficiency. Well-tolerated lactose-free milk could be used to ensure a sufficient dietary supply of Ca in subjects with lactose intolerance.
Very little is known about bile composition in the end stage of chronic renal sufficiency. Patients with this condition are either assigned to a dialysis-transplantation programme, or are treated temporarily with a low-protein diet. Our study was designed to determine bile composition both in a group of ten patients treated with a low-protein diet over a long period of time, and in 11 patients on regular haemodialysis. The patients on haemodialysis were found to have increased bile cholesterol and an increased saturation index in the bile, i.e. changes implying increased risk of cholecystolithiasis. These changes were further enhanced by the effect of a low-protein diet with subsequent increases in cholesterol values and the bile saturation index, as well as a decrease in primary and an increase in secondary bile acids in the bile, i.e. a change in the spectrum of bile acid characteristic for cholecystolithiasis.
Severe gastroduodenal bleeding after renal transplantation is effectively prevented by H2 receptor blockers. New drugs for prophylaxis include proton pump inhibitors. The aim of the present study was to compare the effects of prophylaxis with the H2 blocker ranitidine and with the proton pump inhibitor omeprazole. One hundred seventy-seven consecutive patients were included in a controlled, prospective, randomized study after cadaveric renal transplantation. In one case, ranitidine failed to prevent exsanguination due to duodenal peptic ulcer bleeding. No bleeding was noted in the omeprazole group. There were no significant differences between the groups in hospitalization time, development of renal function, amount of cyclosporin A, prednisone, azathioprine, or methylprednisoline ingested, or laboratory biochemical parameters. We conclude that prophylaxis of severe gastroduodenal bleeding after renal transplantation with omeprazole is effective. Omeprazole is certainly as good as ranitidine; its advantages are a prolonged effect and a simple dosage, independent of graft function development.
The response of the digestive tract after ingestion of milk in lactase insufficiencies was investigated by X-ray. In subjects with lactose intolerance after milk the gastric evacuation is retarded, while there is a considerable simultaneous increase in the transit time through the small intestine. There is also an increased secretion in the small intestine. In the colon, pneumatosis starts from the moment the contrast substance reaches the caecum. These changes are not found after administration of lactose-free milk, where the findings are similar as in controls.
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