Carbohydrate malabsorption in alcoholic pancreatic insufficiency. The effect of pancreatic enzyme therapy on intestinal transit time.

The absorption of rice flour and the mouth-to-cecum transit time of a nonabsorbable carbohydrate were measured by breath hydrogen excretion technique in 10 patients with alcoholic pancreatic insufficiency, to evaluate the underlying mechanisms of carbohydrate malabsorption. Breath hydrogen excretion after ingestion of rice pancakes was significantly higher in patients than in 10 controls, suggesting malabsorption of carbohydrates. Mouth-to-cecum transit time was not significantly different between the two groups. Pancreatic enzyme therapy significantly reduced both fecal fat excretion and the degree of carbohydrate malabsorption, but, in contrast, did not significantly change mouth-to-cecum transit. There was no correlation between the degree of carbohydrate or fat malabsorption and mouth-to-cecum transit time. Carbohydrate malabsorption is common in pancreatic insufficiency and is markedly improved by enzyme supplementation. Mouth-to-cecum transit, however, does not play a major role in carbohydrate or fat malabsorption in these patients.