gastrins and Lactose-Intolerance

The biologic clock that determines the temporal sequence of maturation of digestive and absorptive processes in the gastrointestinal tract is genetically predetermined, but may be modified by dietary, hormonal, or other factors. In general it may be said that the gastrointestinal tract of full-term neonates is capable of digesting and absorbing a nutritionally adequate quantity of dietary protein but capacity is limited. Very low birth weight preterm infants, who are surviving the early neonatal period in increasing numbers, have immaturity of a wide range of digestive and membrane-associated absorptive processes; in addition macromolecular absorption may be increased. Whether a limited capacity to digest food protein results in increased or altered antigenic stimulation of these immature infants remains speculative with present knowledge. Immaturity of intestinal lactase may lead to problems of lactose intolerance, but there is recent evidence that lactase activity may be inducible by milk feeding.

Topics: Absorption; Aging; Amino Acids; beta-Galactosidase; Biological Transport, Active; Cholecystokinin; Dietary Proteins; Digestion; Digestive System; Endopeptidases; Exopeptidases; Fetus; Food Hypersensitivity; Gastric Acid; Gastrins; Humans; Hydrolysis; Infant; Infant, Newborn; Infant, Premature; Intestinal Mucosa; Lactose Intolerance; Pancreas; Pepsin A; Peptide Hydrolases; Secretin; Stomach; Substrate Specificity

Topics: Biliary Tract Diseases; Ceruletide; Cholangiography; Cholelithiasis; Duodenal Ulcer; Endoscopy; Gastrins; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Gastrointestinal Hormones; Humans; Intestinal Absorption; Lactose Intolerance; Pancreatic Diseases; Peptic Ulcer; Radionuclide Imaging; Secretin; Stomach Neoplasms

Topics: Colitis, Ulcerative; Gastrins; Gastrointestinal Diseases; Gastroscopy; Humans; Lactose Intolerance; Malabsorption Syndromes; Peptic Ulcer; Stomach Neoplasms

The authors provide the data obtained during examination of 36 children with celiac disease and 18 children with lactase deficiency. The children's age ranged from 8 months to 15 years. All the children underwent spot biopsy of the gastric and duodenal mucosa followed by immunomorphological PAP-staining of the biopsy specimens and count of the number of gastrin- and somatostatin-producing cells. Gastrin in the blood serum was measured by radioimmunoassay. The children with celiac disease manifested an increase of the number of somatostatin-producing cells in the duodenum and decrease of their number in the pyloric part of the stomach, seen in the acute phase of the disease. The number of gastrin-producing cells remained unchanged. The level of gastrin declined in the acute phase and increased during a remission. The alterations described were found to be related to the atrophic processes in the small intestinal mucosa. In lactase deficiency, no significant alterations were established in the number of pyloric and duodenal endocrine cells or in blood gastrin level.

Topics: Adolescent; Celiac Disease; Child; Child, Preschool; Digestion; Duodenum; Gastrins; Humans; Infant; Lactose Intolerance; Pylorus; Somatostatin

The clinical features, the results of gastric secretory function tests, and the duodenojejunal morphology of six infants (aged 0.42-1.23 years) with anemia and melena considered to be due to latent cow's milk intolerance (LCMI) were compared with the findings in nine infants (aged 0.19-0.87 years) with cow's milk-induced malabsorption (CMI). The infants with LCMI had a short period of breast feeding, normal weight gain without symptoms of malabsorption, and no atopic history. The maximal acid secretion was decreased (p < 0.01) and the concentration of fasting serum gastrin raised (p < 0.01) compared with the controls. Gastric biopsy revealed epithelial degeneration in three and erosion in one out of four samples. The duodenojejunal biopsy revealed slight changes in two samples, the others being normal. The number of eosinophils was increased in four out of six biopsies. Although the number of intraepithelial lymphocytes was increased in LCMI the rise was not as significant as in children with CMI (p < 0.05). We conclude from our results that LCMI seems to be a seperate clinical entity. The determination of fasting serum gastrin, maximal gastric acid secretion and intraepithelial lymphocytes on duodenojejunal biopsy appear to be helpful in making the diagnosis.

Topics: Animals; Breast Feeding; Cattle; Gastric Acidity Determination; Gastric Mucosa; Gastrins; Humans; Infant; Intestinal Mucosa; Jejunum; Lactose Intolerance; Melena; Milk

Topics: Bile Acids and Salts; Cholecystokinin; Colonic Diseases, Functional; Diarrhea; Gastrins; Gastrointestinal Motility; Humans; Lactose Intolerance; Stress, Psychological