D-LACTIC ACIDEMIA AND ACIDURIA IN PEDIATRIC AND ADULT PATIENTS WITH SHORT-BOWEL SYNDROME

D-Lactate produced by abundant intestinal lactobacilli during acidotic episodes in short bowel (SE) patients is commonly regarded as a main factor in the pathogenesis of SE syndrome-associated (D-lactic) acidos is. Since we had observed that gram-positive bacteria, mainly lactobac illi, were abundant even in the absence of acidosis, we studied serum concentrations and urinary excretions of D-and L-lactate in young and adult SE patients, especially during nonacidotic periods. Serum L-lact ate and urinary L-lactate excretion were similar in adults and childre n. Serum D-lactate and urinary D-lactate excretion were higher in SE c hildren than in SE adults. Food consumption affects D-lactate producti on and alters D-lactic acidemia and aciduria. We conclude that D-lacta te is frequently present in serum of SE patients even in the absence o f acidosis. High serum concentrations and urinary excretions may refle ct dietary factors in these patients.