RT Journal Article
SR Electronic
T1 Lactose absorption and mucosal disaccharidases in convalescent pellagra and kwashiorkor children
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 474
OP 478
DO 10.1136/adc.46.248.474
VO 46
IS 248
A1 J. G. Prinsloo
A1 W. Wittmann
A1 H. Kruger
A1 E. Freier
YR 1971
UL http://adc.bmj.com/content/46/248/474.abstract
AB Oral lactose and glucose/galactose loading tests were done in Bantu children convalescing from kwashiorkor and pellagra. Small bowel biopsies and disaccharidase estimations were performed in all except 2 patients. Lactose absorption was more impaired and intestinal lactase levels were lower in the pellagra than in the kwashiorkor group. The fact that diarrhoea after admission to hospital was less common in pellagra than kwashiorkor was ascribed to a lesser lactose load due to the early introduction of a mixed diet in the former group, in comparison with milk feeds only in the latter group. The absence of troublesome diarrhoea while on moderate quantities of lactose in the diet, in the presence of low intestinal lactase levels, but evidence of lactose malabsorption after loading, has a bearing on preventive and therapeutic nutrition programmes in non-Caucasian children. Lactase deficiency is not necessarily synonymous with symptomatic lactose intolerance if the threshold is not exceeded. Concern is expressed that excessive caution against the use of milk may lead to a worsening of infantile malnutrition in developing countries.