[The effect of the FODMAP and rebamipid diet on the activity of disaccharidases in patients with enteropathy with impaired membrane digestion].

Autor:	Baulo EV; Loginov Moscow Clinical Scientific Center., Belostotsky NI; Loginov Moscow Clinical Scientific Center., Akhmadullina OV; Loginov Moscow Clinical Scientific Center., Dbar SR; Loginov Moscow Clinical Scientific Center., Bykova SV; Loginov Moscow Clinical Scientific Center., Parfenov AI; Loginov Moscow Clinical Scientific Center.
Jazyk:	ruština
Zdroj:	Terapevticheskii arkhiv [Ter Arkh] 2023 Mar 30; Vol. 95 (2), pp. 140-144. Date of Electronic Publication: 2023 Mar 30.
DOI:	10.26442/00403660.2023.2.202057
Abstrakt:	Aim: To compare the effect of a diet low in fermentable oligo-, di-, monosaccharides and polyols (fermentable oligosaccharides, disaccharides, monosaccharides and polyols - FODMAP) and rebamipide on carbohydrate tolerance and disaccharidases activity in patients with maldigestive enteropathy (ENMP). Materials and Methods: The study included 61 patients with ENMP with reduced small intestine carbohydrases. Their glucoamylase activity was 100 ng glucose/mg tissue × min (quartile 53, 72), maltase - 504 (quartile 258, 708), sucrase - 43 (quartile 25, 58), lactase - 8 (quartile 4, 20). Group 1 included 19 people on a low FODMAP diet. The 2nd group included 42 patients who were on a normal diet and received rebamipide 300 mg/day. Patients were monitored weekly for 8 weeks. Results: In 16 patients of the 1st group, abdominal pain and stool disorders decreased, in 15 patients, swelling and rumbling in the abdomen stopped. Glucoamylase activity increased to 196 (quartile 133, 446, р <0.024) ng glucose/mg tissue × min, maltase activity increased to 889 (quartile 554, 1555, p <0.145), sucrase activity increased to 67 (quartile 43, 175, p <0.039), lactase activity increased to 13 (quartile 9, 21, p <0.02). After the diet was discontinued, intestinal symptoms in patients of group 1 resumed. In 27 patients of the 2nd group after 4 weeks dyspeptic manifestations decreased, in 34 patients the tolerability of products containing FODMAP improved. Continuation of treatment up to 8 weeks contributed to a further improvement in well-being. Glucoamylase activity increased after 4 and 8 weeks to 189 (quartile 107, 357, p <0.013) and 203 (quartile 160, 536, p <0.005), respectively; maltase - up to 812 (quartile 487, 915, p <0.005) and 966 (quartile 621, 2195, р <0.0012); sucrases - up to 60 (quartile 34, 105, p <0.013) and 75 (quartile 52, 245, р =0.003); lactase - up to 12 (quartile 8, 12, p <0.132) and 15 ng glucose/mg tissue × min (quartile 10, 20, р <0.092). Conclusion: The clinical symptoms of fermentable carbohydrate intolerance and increased membrane enzyme activity are reduced by a low FODMAP diet in patients with ENMT, but clinical symptoms of food intolerance reappear when switching to a normal diet. Treatment with rebamipide improves food tolerance and consistently increases the activity of TSOTS enzymes after 4 and 8 weeks.
Databáze:	MEDLINE
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