A Defect in Disaccharide Metabolism after Gastrojejunostomy

Gryboski, Joyce D.; Thayer, Walter R.; Gryboski, William A.; Gabrielson, Ira W.; Spiro, Howard M.

doi:10.1056/nejm196301102680205

Cited by 38 publications

(6 citation statements)

References 7 publications

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“…Sucrose that disappears from the intestinal lumen might be absorbed intact or be hydrolyzed to its monosaccharide products, glucose and fructose. However, in man no appreciable amount of sucrose appears to be absorbed intact into the blood, for any sucrose that enters blood is excreted quantitatively in urine (16)(17)(18)(19), but only trace amounts are found in urine of humans after a sucrose meal (20)(21)(22)(23). Further, no sucrosuria was found in our subjects as measured by enzymatic assay or by paper chromatography (20,21).…”

Section: Methodsmentioning

confidence: 65%

Intestinal Absorption of Sucrose in Man: The Site of Hydrolysis and Absorption*

Gray¹,

Ingelfinger²

1965

J. Clin. Invest.

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Sucrose, unlike the other common disaccharides, maltose and lactose, has been reported to be absorbed poorly from jejunum in man. The present studies were designed to examine further the absorption of sucrose in normal man. MethodsTwenty-three normal young adults (21 males, 2 females) were studied on 50 occasions. A double-lumen polyvinyl tube with a small, terminal, mercury-filled balloon (6) was swallowed the evening before the study and allowed to move into the small intestine overnight. Subjects were permitted to have a supper containing clear liquids on the day before the study, but they ingested nothing but water for the 12-hour period before begining the experiment. One lumen of the tube was used to collect intestinal samples through an orifice placed just proximal to the terminal balloon. The other lumen, through which the test solution was infused, had its opening 30 cm proximal to the collecting orifice. Position of the tube was checked fluoroscopically before the study, and any coiling in the stomach was removed. When the collecting orifice was a distance of 60 to 100 cm from the incisor teeth, it was found fluoroscopically to be in the duodenum, when 100 to 170 cm in the jejunum, and when 170 to 260 cm in the ileum. At distances exceeding 260 cm, the distal orifice of the tube was often found to be in the colon. These relationships are similar to those previously reported (1,(6)(7)(8)

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Section: Methodsmentioning

confidence: 65%

Intestinal Absorption of Sucrose in Man: The Site of Hydrolysis and Absorption*

Gray¹,

Ingelfinger²

1965

J. Clin. Invest.

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“…Secondary lactase deficiency in adults (Haemmerli et al, 1965) has been encountered following gastrojejunostomy (Gryboski, Thayer, Gryboski, Gabrielson, and Spiro, 1963), bowel resection (Kern, Struthers, and Attwood, 1963), and various other affections of the gut. Combined disaccharidase deficiences were common in coeliac disease of the adult (Plotkin and Isselbacher, 1964).…”

Section: Sugar Transportmentioning

confidence: 99%

Sugar malabsorption due to deficiencies of disaccharidase activities and of monosaccharide transport.

Holzel¹

1967

Archives of Disease in Childhood

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In many societies including our own, carbohydrates play a major part in the total calorie supply. According to the National Food survey figures (Greaves and Hollingsworth, 1964), the average daily diet of adults contains nearly 350 g. of this constituent. Diets of course vary with eating habits and social class, but the dietary carbohydrates are largely ingested as poly-, oligo-, and disaccharides. In the very young, however, the carbohydrate intake may consist almost entirely of disaccharides, though this phase is now getting progressively shorter. As the rapid decrease in breast-feeding has been followed by the early introduction of cereals into the cow's milk formulae, even the infant of only a few weeks of age has also to digest polysaccharides. Sjovall, 1957; Dahlqvist and Borgstrom, 1961) demonstrated that disaccharidase activity in the intestinal lumen was extremely limited and did not account for the amount of carbohydrate absorbed. They further indicated that the majority of disaccharides were absorbed unhydrolysed and split intracellularly, a fact that accorded well with experimental findings (Cajori, 1933;Fridhandler and Quastel, 1955).The problem of localization of the sugar-splitting enzymes was brought nearer its solution by Miller and Crane (1961), who were able to separate the brush-border from the rest of the intestinal mucosa of the hamster, and found that the whole of the enzyme activity of the mucosa was accounted for by this layer. (-galactosidase (lactase) activity had been localized in the microsomes of the rat intestinal mucosa by Doell and Kretchmer (1962), while Dahlqvist and Brun (1962), employing histochemical methods for the recognition of invertase and trehalase in various animal tissues, associated their activity with cytoplasmic granules. As yet there is no definite information concerning the possible relationship of the elements of fine structure of the microvillus with its absorptive and digestive functions. However, two related fractions have been obtained by density gradient centrifugation of tris-disrupted brush-borders from hamster intestinal mucosa, and have been identified as the microvillus cores and their surrounding membranous coats (Overton, Eichholz, and Crane, 1965;Eichholz and Crane, 1965).

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“…An increase in the absorption and urinary excretion of unhydrolyzed lactose and sucrose has been reported in patients with celiac disease (3,4), tropical sprue (5,6), and a variety of other gastrointestinal disorders (4,(7)(8)(9) usually associated with a deficiency of intestinal disaccharidases. The purpose of the present study was to compare the metabolic fate of circulating lac-metabolism of circulating maltose and tose, sucrose, and maltose in adult humans and rats.…”

Section: Introductionmentioning

confidence: 99%

Metabolism of Circulating Disaccharides in Man and the Rat *

Weser¹,

Sleisenger²,

Dickstein³

et al. 1967

J. Clin. Invest.

103

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Summary. The metabolism of circulating disaccharides was studied in adult humans and rats. After iv infusions of 10 g of either lactose, sucrose, or maltose in four adults, no rise in blood glucose was noted. A mean of 8.7 + 1.89 g of the lactose and 6.3 + 1.39 g of the sucrose was excreted in the 24-hour urine sample. Only 0.11 ± 0.03 g of the infused maltose was recovered in the urine, suggesting that the maltose was metabolized.After injection of 14C-labeled lactose and sucrose in rats, 6.2 + 2.7 and 7.6 ± 2.4%, respectively, was oxidized to 14CO2 in 24 hours; 62.1 ± 13.5 and 68.4 ± 10.8% of the respective disaccharides was excreted into the urine. Conversely, after injection of 14C-labeled maltose 54.6 + 7.0% was oxidized to 14CO0 and 4.8 + 3.9% excreted in the urine. The per cent of maltose oxidized to CO2 was similar to that of glucose.In addition to small intestinal mucosa, homogenates of rat kidney, brain, and liver as well as serum were found to have measurable maltase activities.

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A Defect in Disaccharide Metabolism after Gastrojejunostomy

Cited by 38 publications

References 7 publications

Intestinal Absorption of Sucrose in Man: The Site of Hydrolysis and Absorption*

Intestinal Absorption of Sucrose in Man: The Site of Hydrolysis and Absorption*

Sugar malabsorption due to deficiencies of disaccharidase activities and of monosaccharide transport.

Metabolism of Circulating Disaccharides in Man and the Rat *

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