COMPLEX CARBOHYDRATE MALABSORPTION IN EXOCRINE PANCREATIC INSUFFICIENCY

The magnitude of complex carbohydrate malabsorption in exocrine pancre atic insufficiency has not been well quantified in the past. The quant ity of carbohydrate malabsorbed after a rice starch (100 g) meal in 20 patients with chronic pancreatitis (n=10) or pancreatic cancer (n=10) was therefore estimated. Patients had a three day stool fat collectio n (80 g/24 hour fat intake), a lactulose (20 g), and a rice flour (100 g) breath hydrogen test. Normal controls (n=29) had a postprandial H- 2 increase less-than-or-equal-to 14 ppm and malabsorbed (mean (SEM)) 1 .12 (0.44) (range 0-11.10) g of the 100 g of carbohydrate ingested. Pa tients malabsorbed significantly more carbohydrate (11-36 (2-23) (rang e 8.90-32.60) g, F1,47= 29.92, p<0.001). The number of patients with f at (>7 g, n=8) or carbohydrate (increase in H-2 greater-than-or-equal- to 20 ppm, n=10) malabsorption was not different (chi2=0.10, p=0.75). There was a significant correlation between faecal fat and amount of m alabsorbed carbohydrate (r=0.60, F1,17=9.70, p=0.006) and faecal fat a nd stool wet weight (r=0.57, Ft,18=8-67, p<0.009), but not between sto ol wet weight and amount of malabsorbed carbohydrate (r=0.28, F1,17=1. 45, p=0.25). Although patients with exocrine pancreatic insufficiency malabsorb 10%-30% of the ingested complex carbohydrate, the main deter minant of stool wet weight could be faecal fat.