Helicobacter pylori infection and lactose intolerance increase expiratory hydrogen.

Autor: Schnedl WJ; Practice for General Internal Medicine, Dr. Theodor Körnerstrasse 19b, A-8600 Bruck/Mur, Austria., Meier-Allard N; Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010 Graz, Austria., Schenk M; Das Kinderwunsch Institut Schenk GmbH, Am Sendergrund 11, A-8143 Dobl, Austria., Lackner S; Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010 Graz, Austria., Enko D; Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria., Mangge H; Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria., Holasek SJ; Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010 Graz, Austria.
Jazyk: angličtina
Zdroj: EXCLI journal [EXCLI J] 2022 Feb 17; Vol. 21, pp. 426-435. Date of Electronic Publication: 2022 Feb 17 (Print Publication: 2022).
DOI: 10.17179/excli2021-4508
Abstrakt: Infection with Helicobacter pylori ( H.pylori ) may cause dyspepsia and/or unexplained functional nonspecific, gastrointestinal complaints of the irritable bowel syndrome (IBS) spectrum. Hitherto, in H. pylori infected patients with symptoms of the IBS spectrum the occurrence of additional food intolerance/malabsorption is not evaluated. We used a retrospective analysis of charts from 548 patients who presented with gastrointestinal complaints of the irritable bowel syndrome spectrum. An enzyme-linked IgA immunosorbent assay or histologic evaluation of gastric mucosa were used to detect H. pylori infection. A hydrogen breath (H 2 ) test was performed to evaluate fructose malabsorption (FM) and lactose intolerance (LIT). Serum diamine oxidase value of <10 U/ml and a response to a histamine-reduced diet was used to identify histamine intolerance (HIT). We found 293 patients infected with H. pylori , within these were 58 H. pylori patients with LIT, 23 H. pylori LIT patients with FM and 46 H. pylori LIT patients with HIT. Additionally, 13 H. pylori, lactose- and histamine intolerance patients also had FM. The Kruskal Wallis test and pairwise comparison were used to analyze differences of the area under the curve of expiratory hydrogen. In lactose H 2 breath tests compared with LIT-only patients, LIT with H. pylori , LIT and H. pylori with HIT, LIT and H. pylori with FM showed significantly higher exhaled H 2 levels (p=0.022). Pairwise comparison demonstrated H. pylori infected patients with LIT exhaled more H 2 compared to LIT-only (p=0.029). H. pylori with lactose- and histamine intolerance, and H. pylori with lactose-, histamine intolerance and FM compared to H. pylori -only patients indicated a significantly higher occurrence of stomach pain during lactose H 2 breath tests (p=0.012 and p=0.005, respectively). We demonstrate that LIT patients with high expiratory H 2 levels in lactose breath tests may have H. pylori infection and possibly additional food intolerance/malabsorption. Subsequently, besides H. pylori eradication, a dietician is necessary for an individually tailored reduction- or exclusion diet of symptom triggering food components.
(Copyright © 2022 Schnedl et al.)
Databáze: MEDLINE
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