CARBOHYDRATE MALABSORPTION IN CHILDREN WITH SEVERE PROTEIN-ENERGY MALNUTRITION

  • 1 January 1984
    • journal article
    • research article
    • Vol. 36  (4) , 355-365
Abstract
To determine the incidence of carbohydrate malabsorption, particularly lactose malabsorption in Basotho children with severe PEM [protein energy malnutrition] during treatment with a dry skim milk (DSM)-sucrose-oil mixture, 105 children with PEM were submitted to a hydrogen breath test (HBT) after administration of the mixture. Carbohydrate malabsorption occurred more frquently in children with kwashiorkor (28/58) than in those with marasmus (5/33), marasmic kwashiorkor (3/15) and healthy controls (8/34). The positive HBT appeared to be due to lactose malabsorption in at least 2/3 of the childen with kwashiorkor as it turned negative when the challenge was repeated with a lactose-free mixture. In controls malabsorption of carbohydrate (usually lactose) appeared at the age of 22 mo., nearly a year later than in PEM. Diarrhea occurred in 23 cildren with PEM and particularly in those with carbohydrate malabsorption. In 20 children Giardia was found in the stools without any observable effect on carbohydrate malabsorption. The findings support the cautious use of physiological doses of lactose in the treatment of severe PEM.