Diffuse White Deposits of the Duodenum May Suggest Delayed Glucose Absorption

Abstract

Background:The aim of the present study was to evaluate the relationship between white deposits observed in the duodenum and malabsorption of nutrients. Methods: 132 consecutive subjects presenting with diagnostic upper endoscopy were recruited in this study. 13 C-acetate was given intraduodenally in 65 patients and 13 C-glucose in 67 patients. At the end of endoscopy, the tip of the endoscope was placed in the second part of the duodenum and 20 mL water containing 100 mg 13 C-substrate was sprayed onto the duodenal mucosa. Breath samples were taken at baseline and at 10 min intervals. Results: There were no significant differences between 13 CO2 excretion and the grade of white deposits after giving intraduodenal 13 C-acetate. A delay in the 13 CO2 excretion curve in patients with a body mass index of more than 26 was noted after giving 13 C-glucose and there was a significant delay in 13 CO2 excretion in the 'diffuse' group as compared with the other two groups. The mean values of 13 CO2 were significantly lower in obese patients than in non-obese subjects. Conclusion: Results from the duodenal infusion study using stable isotopes demonstrate a close association between diffuse white deposits on the duodenal mucosa and delayed glucose absorption.