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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Patients with functional bowel disorder have disaccharidase deficiency: A single-center study from Russia
Saria Dbar, Olga Akhmadullina, Elena Sabelnikova, Nikolai Belostotskiy, Asfold Parfenov, Svetlana Bykova, Sergey Bakharev, Elena Baulo, Alexandra Babanova, Lilia Indeykina, Tatyana Kuzmina, Tatiana Kosacheva, Aleksey Spasenov, Alina Makarova
Saria Dbar, Olga Akhmadullina, Svetlana Bykova, Sergey Bakharev, Elena Baulo, Alexandra Babanova, Tatiana Kosacheva, Non-inflammatory Bowel Diseases, Moscow Health Department, Moscow Clinical Scientific Center n.a. A.S. Loginov, Moscow 111123, Russia
Elena Sabelnikova, Moscow Health Department, Moscow Clinical Scientific Center n.a. A.S. Loginov, Moscow 111123, Russia
Nikolai Belostotskiy, Pre-Clinical Research Laboratory, Moscow Clinical Scientific Center Named after A.S. Loginov MHD, Moscow 111123, Russia
Asfold Parfenov, Department of Bowel Pathology, Moscow Health Department, Moscow Clinical Scientific Center n.a. A.S. Loginov, Moscow 111123, Russia
Lilia Indeykina, Alina Makarova, Laboratory of Functional Diagnostics of Intestinal Diseases, Moscow Health Department, Moscow Clinical Scientific Center n.a. A.S. Loginov, Moscow 111123, Russia
Tatyana Kuzmina, Nutraceuticals Laboratory, Moscow Health Department, Moscow Clinical Scientific Center n.a. A.S. Loginov, Moscow 111123, Russia
Aleksey Spasenov, Department of Medical Statistics, Moscow Health Department, Moscow Clinical Scientific Center n.a. A.S. Loginov, Moscow 111123, Russia
Author contributions: Parfenov A and Sabelnikova E are the guarantors and designed the study; Dbar S and Akhmadullina O participated in the acquisition, analysis and interpretation of the data, and drafted the initial manuscript; Belostotskiy N, Bykova S, Bakharev S, Baulo E, Babanova A, Indeykina L, Kuzmina T, Kosacheva T, Spasenov A and Makarova A revised the manuscript critically for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Ethical Committee of Moscow Clinical Scientific Center n.a. A.S. Loginov, Moscow Healthcare Department, Moscow, Russia.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Saria Dbar, MD, Academic Fellow, Non-inflammatory Bowel Diseases, Moscow Health Department, Moscow Clinical Scientific Center n.a. A.S. Loginov, Shosse Entuziastov 86, Build 1, Moscow 111123, Russia. saradbar@yandex.ru
Received: January 9, 2021
Peer-review started: January 9, 2021
First decision: January 29, 2021
Revised: February 12, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: June 16, 2021
BACKGROUND
Functional bowel disorder (FBD) may be caused by a decrease in disaccharidase activity. Thus, the timely diagnosis of disaccharidase deficiency could lead to a better prognosis in patients with this condition.
AIM
To determine the potential value of intestinal disaccharidases glucoamylase, maltase, sucrase, and lactase in understanding the etiology and pathogenesis of FBD.
METHODS
A total of 82 FBD patients were examined. According to the Rome IV criteria (2016), 23 patients had diarrhea-predominant irritable bowel syndrome (IBS), 33 had functional diarrhea, 10 had constipation-predominant IBS, 4 had functional constipation, and 12 had mixed IBS. The Dahlqvist method was used to measure disaccharidase activity in the brush-border membrane of mature enterocytes of the small intestine, in duodenal biopsies obtained during esophagogastroduodenoscopy.
RESULTS
Lactase deficiency was detected in 86.5% of patients, maltase deficiency in 48.7%, sucrase deficiency in 50%, and glucoamylase deficiency in 84.1%. The activities of all enzymes were reduced in 31.7% of patients, and carbohydrase deficiency was detected in 63.5% of patients. The low activity of enzymes involved in membrane digestion in the small intestine was found in 95.2% of patients.
CONCLUSION
In 78 of the 82 patients with FBD, gastrointestinal symptoms were associated with disaccharidase deficiency.
Core Tip: Our study has shown that patients with functional bowel disorders (FBDs) often had a deficiency of intestinal enzymes. We supposed that there can be a different mechanism for developing FBD: A damage of the small intestine mucous membrane may result in a decreased activity of the enzymes on the brush border of enterocytes, which leads to the disorder of carbohydrates' hydrolysis and the accumulation of osmoactive substances in the lumen of the small intestine, in its turn it causes a bacterial overgrowth in the small intestine, stool disorder, abdominal pain and bloating. The timely diagnosis of disaccharidase deficiency could lead to a better prognosis in patients with FBD.
