Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption

Abstract

The aim of this retrospective study was to analyze the concomitant prevalence rates for lactose malabsorption (LM), fructose malabsorption (FM), and histamine intolerance (HI) in patients with so far unexplained gastrointestinal (GI) symptoms. A total of 439 outpatients, who presented unclear abdominal discomfort, underwent lactose (50 g) and fructose (25 g) hydrogen (H2) breath tests. Additionally, serum diamine oxidase (DAO) measurements were performed. Individuals with low serum DAO activity (<10 U/mL), GI symptoms, and response to histamine-free diet were diagnosed with HI. Of all 439 patients, 341 (77.7%) were found with 7 various GI conditions. In total, 94 (21.4%), 31 (7.1%), and 100 (22.8%) individuals presented LM, FM, or HI only, whereas 116 (26.4%) patients showed an overlap of GI entities investigated here. Interestingly, 89 out of 241 (36.9%) individuals with carbohydrate malabsorption were also diagnosed with HI (LM + HI: 52 [11.8%], FM + HI: 23 [5.2%], and LM + FM + HI 14 [3.2%] individuals). In conclusion different combinations of LM, FM, and HI are present in individuals with unclear abdominal discomfort/pain. In clinical practice we suggest testing for LM, FM, and additional HI in the diagnostic work-up of these patients. Depending on these various diagnoses possible, patients should get an individualized dietary advice.

Circadian profiling reveals higher histamine plasma levels and lower diamine oxidase serum activities in 24% of patients with suspected histamine intolerance compared to food allergy and controls

“…A study including 439 patients with unclear abdominal discomfort identified fructose (5.2%) and primarily lactose (11.8%) intolerance as a frequent concomitant in histamine intolerance 32. In conformity with this study, we also demonstrated that carbohydrate intolerances are frequently associated with histamine intolerance.…”

Benign Pancreatic Hyperenzymemia (Gullo Syndrome), Histamine Intolerance, and Carbohydrate Malabsorption

“…Benign pancreatic hyperenzymemia (Gullo syndrome), histamine intolerance, and carbohydrate malabsorption Wolfgang J. Schnedl, MD, Dietmar Enko, MD, Harald Mangge, MD, Michael Schenk, MD, Sonja Lackner, MSc, and Sandra J. Holasek, PhD in symptoms due to bacterial metabolism and fermentation in the colon. Various combinations of malabsorption were reported in patients with gastrointestinal malabsorption syndromes (2).…”

β-thalassemia minor, carbohydrate malabsorption and histamine intolerance

“…These food components are not absorbed and digested properly during GI passage, and then unabsorbed food results in symptoms due to bacterial metabolism and fermentation in the colon. Recently various combinations of malabsorption/intolerance syndromes in patients with GI malabsorption were reported [3]. …”

“…In Northern Europe β-thalassemia is a rare disease but the number of patients is, due to mobility and migration, significantly growing [2]. Gastrointestinal (GI) malabsorption is caused mainly by carbohydrates (lactose and fructose), biogenic amines (e.g., histamine), and proteins (gluten), and shows nonspecific abdominal symptoms [3]. In two patients with β-thalassemia minor we tested GI malabsorption, and diagnosed carbohydrate and histamine malabsorption.…”