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P095. Disaccharidases activity in children with inflammatory bowel disease

S.A. Wiecek, H. Wos, U. Grzybowska-Chlebowczyk, I. Radziewicz-Winnicki

Silesian Medical University, Katowice, Poland

Background: Etiopathogenesis of Inflammatory Bowel Diseases is very complex and not well explain. Environmental, genetic and dietary factors play important role. The inflammatory process in the course of Inflammatory Bowel Disease (IBD) may also involve the upper alimentary tract and small bowel. It seems that IBD might promote co-existence of decreased disaccharidase activity.

Aim Of the study was the evaluation of lactase, saccharase and maltase activity and its decreased activity incidence in patients with various forms of Inflammatory Bowel Diseases (Crohn's disease, ulcerative colitis, lymphocytic colitis and non-specific undetermined colitis).

Patients and Methods: The study comprised 65 children, aged 3–18 years (mean age 14 years). We diagnosed (following the Porto criteria) various forms of IBD: in 15 children – Crohn's disease, in 20 – ulcerative colitis, in 10 – lymphocytic colitis, and in 20 – undetermined colitis.

During a routine endoscopy of the upper part of the alimentary tract we took biopsy specimens from the descending part of the duodenum. In these bioptates we determined lactase, saccharase and maltase activity using the Dahlquist's method.

Results: Decreased lactase activity in the bioptates taken from the small bowel mucosa was most frequently observed in patients with Crohn's disease (5/15–30%), whereas, the least frequently in children with lymphocytic colitis (in 1/10 – 10%). In the patients with ulcerative colitis and non-specific undetermined colitis the frequency of decreased lactase activity in the small bowel mucosa corresponded to the incidence of lactose intolerance in the population of Polish children (about 20%). Whereas, the lowest mean values of lactase activity were found in the children with Crohn's disease and ulcerative colitis (1.7–2.5 U/1 g).

Decreased saccharase activity in the bioptates taken from the small bowel mucosa was most frequently observed in patients with lymphocytic colitis (in 5/10 – 50%) and ulcerative colitis (9/20 – 45%), whereas, the least frequently in children with non-specific undetermined colitis colitis (in 8/20–40%).

Decreased maltase activity in the small bowel mucosa was most frequently observed in patients with Crohn's disease (in 5/15 – 30%), whereas, the least frequently in children with ulcerative colitis (in 3/20 – 15%). Whereas, the lowest mean values of maltase activity were found in the children with Crohn's disease (5.4 U/1 g). The lowest mean values of saccharase activity were observed in patients with lymphocytic colitis and ulcerative colitis (2.7–3.3 U/1 g).

Conclusions: Therefore, it seems reasonable to perform diagnostics examinations aimed at lactase, saccharase and maltase intolerance and to initiate the diet treatment in children with Inflammatory Bowel Disease.