Analysis of feces for carbohydrates in infants: decoding, norm and deviations. Carrying out a fecal analysis for carbohydrates in infants: the purpose and interpretation of the results of the study Benedict's fecal analysis

Milk is the first food product that a person eats. It contains the required amount of proteins, fats, vitamins, minerals and carbohydrates, making it an ideal food for newborns and children under the age of several months.
Unfortunately, children do not always tolerate milk well; there is a hereditary disease called lactase deficiency, in which the body does not produce the enzyme lactase, which breaks down the carbohydrate in milk (lactose). This condition is quite dangerous for any baby: not only does the disease cause discomfort (abdominal pain, increased gas formation), it also deprives the child of the opportunity to receive nutrients, which leads to weight loss and other consequences. In order to make such a diagnosis, it is necessary to analysis of feces for carbohydrates.

Essence and sensitivity of the method

Simple carbohydrates are able to participate in chemical reactions; so, they have the ability to restore copper ions in some compounds, changing their color. When analyzing feces, the sample is first centrifuged with a small amount of water, and then a reagent is added to it and the color change is observed. If it remains unchanged, light blue, then there are no carbohydrates in the feces - 0%. When the color becomes different, it means the presence of monosaccharides in the feces. For example, green color corresponds to a carbohydrate content of 0.05-0.15%, yellow - 0.5-0.75%, and red - 2% or more.

It must be said that this test detects the presence of not only lactose in the stool, it is not for nothing that it is called the “carbohydrate analysis”, and not the “lactose analysis”. It also shows a positive result in response to the presence of other simple carbohydrates, of which there are quite a few: glucose, fructose, maltose ... So, the test can “deceive”?

Do not rush to such conclusions. It's just that diseases in which other carbohydrates are not absorbed are much less common than lactase deficiency, so in most cases the presence of carbohydrates means this particular disease. In addition, the clinical picture also testifies in favor of the diagnosis: what else can you think about when a child gains weight poorly from birth, worries after eating and does not sleep peacefully at night due to colic? In general, the test is considered reliable, so mothers do not have to worry about its reliability and do not look for the truth by taking the test several times.

Normal amount of carbohydrates in feces

Children from one year old and adults should not have carbohydrates in the feces, that is, the result of the analysis is normally 0%. Even with an extreme love of sweets, these substances are guaranteed to be absorbed as they pass through the stomach and intestines. The digestion of monosaccharides begins in the mouth under the action of saliva and continues throughout the entire digestive tract, so they simply do not reach the final sections of the colon.

But in babies of the first year of life, they may be present. Ideally, if at this time their value will be 0-0.25%. Sometimes, at the age of a child up to six months, the indicator rises to 0.5 (maximum 0.6)%, but this cannot be considered a criterion for the disease. The result of 0.7-1% is already considered "suspicious", such children should be monitored and re-examined. And if the feces contain more than 1% carbohydrates, this clearly indicates the presence of lactase deficiency and requires treatment.

Ancillary studies for the analysis of feces for carbohydrates

Many analyzes "work together", that is, they confirm the results of each other. As for the study of feces for carbohydrates, he also has an "ally": a test for acidity. Normally, the acidity of the stool is 5.5% or more, and with lactase deficiency, the child's feces change their reaction and become acidic, that is, the pH value drops relative to the indicated figures, indirectly confirming the results of the carbohydrate test. Thus, these two studies can be done together to definitely confirm the presence or absence of the disease.
The need for a stool carbohydrate test occurs in about one in 10-15 newborn babies. Fortunately, it does not always show a positive result. Therefore, if your baby was prescribed this diagnostic procedure, you should not worry ahead of time: perhaps everything is in order and no treatment is needed.

The mother of a five-month-old child turned to the pediatrician. Complains of restless behavior and poor sleep in the baby recently, the presence of yellowish loose stools and flatulence. Weight gain is slightly below normal. The necessary tests were carried out, including the analysis of feces for carbohydrates. The result is determined - 0.25%, which is the norm. During a conversation with the mother, it turned out that a few weeks ago the child began to introduce complementary foods, however, as it turned out, they did it in the wrong way, adding new foods to the diet too quickly and in large quantities. This is what gave rise to these complaints. After the normalization of nutrition, all symptoms disappeared.

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Periodically donating feces for carbohydrates is useful for any child. Even adults at least occasionally need to check feces, since the coprogram provides complete information and can timely identify certain disorders, pathologies and the development of diseases.

It is useful for a newborn to take an analysis from the point of view that his digestive system is just being formed. Checking feces for carbohydrates in infants will allow you to identify digestive disorders in time, adjust nutrition and prescribe appropriate treatment. One of the most common methods for studying and detecting carbohydrates in the feces of a child is the Benedict test.

Analysis features

The Benedict method is designed to study feces for sugars, disaccharides, maltose (natural disaccharides), mono- and polysaccharides. Of particular danger are the reducing disaccharides - maltose, lactose and galactose.

The analysis of feces for carbohydrates in infants reveals the absence or presence of violations of the processes of splitting and absorption of lactose and carbohydrates.

There are two enzymes (lactase and lactose). They are closely related. If the child is deficient in lactase, which breaks down lactose, then breast milk in the diet of the newborn is not completely absorbed and is not fully absorbed. Against this background, lactose intolerance develops. That is, the body cannot process lactose, which provokes the corresponding problems.

Symptoms of carbohydrate digestion disorder

Lactase deficiency has certain symptoms. As a rule, the earlier it is detected in an infant, the easier it will be to cope with the disorder as a result. Before looking for indicators of carbohydrates in the baby's feces, parents should notice signs of intolerance.

Typical symptoms of lactose intolerance are:

• regular liquid stool with a foamy structure;
• the presence of a sharp;
• bloating;
• colic;
• gases;
• during and after breastfeeding the baby is crying;
• weight can be gained poorly or fall.

A sour smell is associated with an increase in the acidity of the stool in a child. Normally, the analysis of stool pH is 5.5, but with lactase deficiency, the indicator can become approximately 4.

If you notice the corresponding symptoms, you should immediately consult a doctor. He will check the level of carbohydrates in the stool and be able to determine what affects their content, how to cope with disruption digestive system in children under one year old. You can not ignore the signs, as well as self-medicate. Only the result of the analysis will allow us to say exactly what provoked the insufficiency and how to deal with it.

Types of lactase deficiency

Lactose intolerance is a disorder in which milk sugar is not sufficiently absorbed by the baby's intestines. Violation is divided into two types.

Another question is whether this disease is dangerous or not. Should he be wary?

What is the danger of lactose intolerance?

In an adult, the rejection of lactose, that is, milk, will not cause any special problems. But infant He feeds exclusively on milk, so lactose intolerance is a serious test for him. In infants, the stomach is not properly formed, because the only product that it can digest is milk.

With a deficiency of lactase, breast milk will not be digested. As a result, development will stop. Breast milk is unique in its composition and properties, since it contains over 400 different substances and enzymes, including protein, fats, vitamins, carbohydrates, etc.

Lactose is a milk saccharide that is broken down and converted into galactose and glucose. Glucose, in turn, serves as the main source of energy for child's body. Galactose is needed for the development and normalization of the central nervous system.

Insufficient assimilation of components leads to a decrease normal level zinc, potassium, magnesium. Without breast milk the baby will not be able to get protein, glucose and calcium. So it is not difficult to assess the severity of the disease.

To pass the analysis for carbohydrates, the child's feces themselves are required directly. It just needs to be assembled properly. The feces that are collected taking into account certain recommendations are suitable for analysis.

Therefore, it is better to familiarize yourself in advance with how to properly collect feces. In fact, there is nothing difficult in how to collect feces from a baby.

Stick to a few simple rules:

• do not use an enema to remove feces;
• do not give your child a laxative;
• specimens must be delivered to the study a maximum of 4 hours after a bowel movement;
• 2-3 days before sample collection, do not give any medication;
• stick to the standard feeding regimen;
• do not add new foods to the diet before the study;
• analysis requires at least 1 teaspoon of feces;
• you need to bring them in a special sterile container, which are sold in pharmacies.
• samples from a diaper or diaper will not work, there is a risk of getting incorrect results, that is, the study of feces for carbohydrates will not be true.

Only in this way will the identified amount of carbohydrates correspond to the real state of affairs. Carbohydrates in the stool can tell about certain disorders that should be addressed immediately. If the norm is exceeded and contains more than the prescribed level, then the doctor will prescribe an individual treatment for the child.

What do the results say?

Carbohydrates are almost always present in feces. Only there is a certain norm of their content. The feces may contain a pathological level, at which treatment should be promptly started.

You can check the table or talk directly with the doctor after he receives the results of the study. The carbohydrate content is given as a percentage.

The normal result is a percentage between 0 and 0.3%. If about 0.3-0.5% was detected, then this indicator indicates a slight excess of carbohydrate levels. But 0.5-1% and 1% and above are, respectively, a significant and excessive (pathological) excess.

The decoding is extremely simple, because even parents will not be difficult to guess whether everything is fine with stool tests, or whether treatment will be required to restore the digestive system.

It is important to understand that elevated level carbohydrates is only result of the analysis, instead of the diagnosis. That is, it cannot be used to diagnose the final lactase deficiency. This violation occurs with an imbalance of microflora, an unformed enzymatic system. The main task of the doctor is to normalize the functioning of the digestive system. How this will be done depends on the specific situation and the individual characteristics of the baby's body.

Often, a study on the level of carbohydrates in the feces is carried out to detect a lack of lactase in the baby. This disease causes a lot of inconvenience to both the child and his parents, and can affect the further development of the baby. Suspicion of lactose intolerance in newborns is so common that parents need to familiarize themselves with the process of this examination and the symptoms of the disease.

Lactase is a special enzyme that is produced in the body of a child to break down the carbohydrate lactose that enters his body through breast milk. Some children suffer from a lack of this enzyme, which prevents the milk from being fully digested. That is why the analysis of carbohydrate content is important for the health of the newborn.

Symptoms for analysis

Certain symptoms that manifest themselves in children with lactase deficiency are fixed.

1. Slow development. In this case, the baby's body cannot absorb enough nutrients from milk. So that this fact does not go unnoticed, you should regularly weigh the newborn and compare it with the indicators that the norm describes for its age. If there is a lag in the weight or height of the baby, it is necessary to pass the described analysis.
2. Change in the child's stool and the frequency of bowel movements, reaching 10 times a day. The presence of foam, mucus and a sour smell indicates a possible illness.
3. Constipation is often observed.
4. Manifestation of allergic reactions.
5. When detecting pallor of the skin and mucous membranes of the baby.

If any of these symptoms appear, you should consult a doctor and get a stool test. The diagnosis of "lactase deficiency" can only be made by a doctor after conducting the necessary tests.

The analysis is designed to detect the level of carbohydrate content in the feces, change its acid-base level, as well as count proteins, leukocytes and fatty acids. Such an analysis has the following indicators.

1. The amount of carbohydrates is the main indicator, since undigested lactose is excreted from the body in the feces. In infants, the content rate is no more than 1% carbohydrates, and this percentage gradually decreases to 0.5%
2. In the colon, lactose is broken down into lactic and acetic acids, and thus acidity increases in the feces. The norm sets a pH of at least 5.5, and at lower rates, the child may have lactose deficiency.
3. Elevated inflammatory protein and white blood cells indicate the presence of inflammation in the intestinal area.
4. Fatty acids are indicative of the malabsorption of nutrients that occurs with lactose intolerance.

Conducting a study is not difficult for infants, which is why it is done in almost all newborns. The interpretation of the obtained indicators should be carried out at a doctor's appointment, since if the analysis does not meet the standards, but the above symptoms are absent, only observation of the baby is required.

If after some time a re-analysis is carried out, the decoding of which will give a positive result, we can conclude that the disease is absent, and the failures are due to the physiology of the baby's body.

Study preparation

In order for the analysis to show reliable results, it is necessary to adhere to certain rules when collecting it.

1. You can not collect the remnants of feces from diapers or diapers - use special colostomy bags or oilcloth on which you need to put the child. It should be noted that the study requires the liquid part of the feces.
2. Collected material should be brought for analysis as soon as possible after collection. It should not be stored in the refrigerator for more than 10 hours. The optimal time for the delivery of biomaterial is 4 hours after collection.
3. Defecation should be spontaneous.
4. Feed the baby on the eve of the analysis should be in the usual way.
5. The mother's diet should contain the foods she eats during daily feedings.
6. The minimum amount of feces for analysis should be at least one teaspoon.
7. Feces must be placed in a sterile container. It is better to use a special container sold in a pharmacy.

If the analysis shows that the baby has lactose intolerance, you do not need to self-medicate, since proper treatment only a doctor can prescribe, having considered the symptoms and the results of the study. Many mothers decide to stop breastfeeding a baby, but this measure should only be taken as a last resort - the nutrients in her milk play a crucial role in the development of the baby.

[02-031 ] Carbohydrate content in feces

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Determination of carbohydrate content in feces, used to diagnose carbohydrate malabsorption.

Russian synonyms

SynonymsEnglish

Carbohydrates, Stool analysis; Sugars, Stool analysis.

Research method

Benedict method.

Units

% (percentage).

What biomaterial can be used for research?

How to properly prepare for research?

• Exclude the intake of laxatives, the introduction of rectal suppositories, oils, limit the intake of medications that affect intestinal motility (belladonna, pilocarpine, etc.) and the color of feces (iron, bismuth, barium sulfate), within 72 hours before collecting feces.

General information about the study

Carbohydrates are the main source of calories in the human diet. They can be contained in food in the form of mono-, di-, oligo- and polysaccharides. In the gastrointestinal tract, complex carbohydrates are gradually broken down. In the final step, brush border enzymes hydrolyze disaccharides to monosaccharides, which are then absorbed in the small intestine. Congenital or acquired deficiency of enzymes or diseases of the small intestine (,) are accompanied by malabsorption - malabsorption - of carbohydrates. It has now been established that carbohydrate deficiency is much more common than previously thought. Moreover, there is evidence of the role of this condition in the development of, and other diseases of unknown etiology. On the other hand, timely diagnosis and nutritional changes can significantly improve overall health and relieve patients of these symptoms.

The most common type of carbohydrate malabsorption is. More often it is acquired in nature, develops gradually and manifests itself in adulthood. A rarer, hereditary form of the disease makes itself felt already in infancy. Since lactose in breast milk is the predominant source of energy for the growth and development of the infant, hereditary lactase deficiency is expressed primarily in the form of a sharp delay in weight gain. Other sugars of clinical significance include fructose and the alcohol sorbitol. Insufficiency of their absorption can also be acquired or congenital. Trehalose and sucrase-isomaltase deficiency is much more rare diseases. It should be noted that regardless of the type of sugar, the presence of a large amount of undigested carbohydrates in the intestines is accompanied by the same symptoms: an osmotic effect, leading to the entry of excess fluid into the intestinal lumen and causing diarrhea, enhanced fermentation of the bacterial flora with increased gas formation and impaired peristalsis, causing pain.

The leading role in the diagnosis of carbohydrate malabsorption belongs to laboratory research methods. Fecal carbohydrate determination is a non-invasive and convenient way to estimate the total carbohydrate content in feces as a percentage. The study is carried out in the presence of symptoms of carbohydrate malabsorption and chronic diarrhea in adults, as well as in cases of suspected congenital lactase deficiency in infants. It should be noted that the analysis evaluates the total amount of all types of carbohydrates, while a separate measurement of the amount of glucose, fructose, lactose or any sugars is not performed.

Carbohydrate malabsorption may be transient (temporary). This form of malabsorption most often occurs after an acute intestinal infection. In addition, dietary habits can also have a significant impact on the rate of absorption of carbohydrates. So, for example, an excess of sorbitol in food inhibits the absorption of fructose, therefore, when interpreting the result of the study, additional anamnestic, laboratory and instrumental data should be taken into account. Preparing for the test (avoiding certain drugs) is also very important.

What is research used for?

• For diagnosing carbohydrate malabsorption.

When is the study scheduled?

• In the presence of symptoms of carbohydrate malabsorption (common abdominal pain, increased gas formation, diarrhea), especially when indicating their appearance after eating foods rich in carbohydrates;
• in the presence of chronic diarrhea;
• in case of violation of the prescribed weight gain in newborns.

What do the results mean?

Reference values

For children under 1 year: 0 - 0.25%.

Causes of an increase in the level of carbohydrates in the feces:

• acquired or congenital deficiency of various carbohydrases (lactase, sucrase, maltase, isomaltase);
• diseases of the small intestine (celiac disease, Crohn's disease);
• transient malabsorption of carbohydrates (post-infectious);
• nutritional features.

Decreased carbs in the stool is of no diagnostic value.

What can influence the result?

• Features of the diet;
• patient's age;
• acute intestinal infection in history;
• reception antibacterial drugs, pro- and prebiotics.



Important Notes

• The result of the analysis should be evaluated together with the data of additional anamnestic, laboratory and instrumental studies.
• The study is not intended to differential diagnosis insufficiency of various carbohydrases.

• MCM6 gene. Study of the genetic marker C(-13910)T (regulatory region of the LAC gene)
• Acute bacterial intestinal infections - detection and confirmation

Who orders the study?

Gastroenterologist, pediatrician, general practitioner.

Literature

• Born P. Carbohydrate malabsorption in patients with non-specific abdominal complaints. World J Gastroenterol. 2007 Nov 21;13(43):5687-91.
• Gibson PR, Newnham E, Barrett JS, Shepherd SJ, Muir JG. Review article: fructose malabsorption and the bigger picture. Aliment Pharmacol Ther. 2007 Feb 15;25(4):349-63. Epub 2007 Jan 8.
• Gudmand-Høyer E. The clinical significance of disaccharide maldigestion. Am J Clinic Nutr. 1994 Mar; 59(3 Suppl):735S-741S. review.

Content

One of the most important components of food and the main suppliers of energy for the body are carbohydrates. In case of violation of the process of their assimilation (malabsorption), provoked by acquired or congenital enzymatic deficiency, a general deterioration in the state of human health is observed. Laboratory analysis of feces for carbohydrate content allows you to diagnose various pathologies and prescribe an effective therapy that relieves the patient of unpleasant symptoms.

What are carbohydrates in feces

There is a laboratory study of feces, after deciphering the results of which the quantitative content of sugars, disaccharides, poly- and monosaccharides, maltose in the feces is established. If these substances are detected, further diagnostics of the patient is carried out to establish the causes of the pathological process. Laboratory research is usually used to determine the presence of lactose intolerance in newborns and children in the first year of life.

Analysis of feces for carbohydrates

The study is based on the ability of simple carbohydrates to act as a catalyst for various chemical reactions. These substances restore copper cations, which are part of inorganic and organic compounds. In the course of a chemical reaction, the color of the component changes, due to which the laboratory assistant can draw conclusions about the presence of poly- and monosaccharides in biosamples.

After removing the feces from a sterile container, add a little distilled water to it. Next, the material is subjected to centrifugation, it is mixed with a chemical reagent. By the way the color has changed, one can judge the quantitative content of carbohydrates in feces:

If the color of the feces, when combined with the reagent, retained its original light blue color, then the cause of digestive disorders is not associated with improper absorption of carbohydrates. To get the most reliable results of the analysis, it is important not to change the usual diet, not to follow any diet on the eve of the delivery of the material to the laboratory.

Indications for analysis

The detection of carbohydrates in faeces can be an independent diagnostic study or carried out in combination with other tests. As a rule, along with this, a fecal coprogram, fecal examinations to detect dysbacteriosis, and genetic markers of lactase deficiency are carried out. Biochemical analysis do not spend on children during the first 3 months of life, because at this time the processes of digestion are just beginning to form, and the result will be uninformative. The indications for the study are:

• stomach ache;
• frequent regurgitation;
• poor weight gain in a child;
• diarrhea;
• intestinal dysbacteriosis;
• increased gas formation, bloating;
• constipation.

Training

In order to obtain reliable results as a result of the study of fecal masses for the presence of carbohydrates, it is important to properly prepare for the test. For this, doctors recommend:

• 3 days before this, exclude the use of rectal suppositories, do not do cleansing enemas;
• a week before the procedure, stop taking medications that can affect the nature of the stool (stimulate diarrhea, constipation), increase peristalsis, and contain dyes;
• a day before the study, do not change the usual diet, but give up alcohol and bright, coloring vegetables and fruits such as beets, asparagus, etc .;
• 2-3 days before the sample is taken, do not undergo diagnostic studies using contrast agents (MRI, CT, etc.).

How to take a stool test

If feces are taken for carbohydrates from an infant, it is undesirable to take a sample from the surface of the diaper, since the liquid part of the feces, which is necessary for the study, is absorbed by the absorbent inside the disposable panties. For adults, the procedure for collecting material for analysis is as follows:

• empty the bladder;
• carry out hygiene procedures for the external genitalia and anal outlet with boiled water using soap (the product should be free of dyes or flavors);
• after defecation, feces are collected with a special spatula in a dry, clean container with a lid (you can buy it at a pharmacy);
• the amount of biological material may vary, but it must be at least 1 tsp;
• samples are taken from the middle part of the faeces, while taking only liquefied masses;
• it is not recommended to collect samples directly from the toilet: if water gets on them, this will cause incorrect results;
• after collecting the biomaterial, the container is tightly closed with a lid, indicate your data on it (name, age, date of collection) and within 4 hours the feces must be brought to the laboratory where the study will be carried out.

Decryption

The level of carbohydrates in feces is determined as a percentage. The results of the analysis differ in children of different ages and adults. Often the cause of unfavorable indicators is dysbacteriosis or immaturity of enzymatic systems. At the same time, the pediatrician conducts therapeutic measures and corrects microbiological disorders in the baby's intestines. Laboratory research feces can also be given to adults, with a common cause of carbohydrates in the faeces being a lack of pancreatic enzymes.

The ideal option is the absence of carbohydrates in the feces of children and adults, which indicates a normal state of health. Even those with a sweet tooth break down these organic substances, and then absorb the products of their metabolism. Carbohydrates are processed already at the stage of getting into oral cavity through enzymes in saliva. During the passage of food through the gastrointestinal tract gastrointestinal tract) are fully digested.

An adult should not have carbohydrates in the feces, otherwise a pathological condition is fixed and additional examinations are prescribed. The norm of carbohydrates in the feces of a baby up to 12 months is 0-0.25%. Indicators exceeding these figures are a deviation from the norm. At the same time, if the analysis showed a result of 0.3-0.5%, this is a slight deviation, and with indicators of 0.6-1%, the average deviation is recorded. If the stool contains 1% or more carbohydrates, such a deviation is considered significant. The norms of carbohydrate content in feces in children according to visual characteristics:

High carbohydrate content

Exceeding the amount of sugar in the feces is allowed only in small children. The rate of carbohydrates in their feces varies from 0.001 to 0.25%. If the baby does not have problems with appetite and there is an active weight gain, pediatricians do not consider it a deviation and 0.5-0.6%. In cases where a more significant increase in the content of carbohydrates in the feces of the baby is recorded, it becomes necessary to further examine the child for lactase deficiency.

Reasons for deviations

Exceeding the allowable amount of carbohydrates in the stool is characteristic of lactase deficiency, in addition, this may indicate a violation of the absorption of other sugars. The analysis may show a false positive result if the child has taken ascorbic acid, antibiotics, salicylates, and other drugs shortly before him. In addition, an unreliable result can be obtained if the child ate a low-lactose mixture before the analysis.

With low and moderate deviations from the norm in the content of carbohydrates in the feces of the child, the patient continues to be monitored and, over time, an acidity test and another study are prescribed. With a carbohydrate index above 1% and the presence of a certain clinical picture the baby is diagnosed with lactase deficiency and prescribed treatment. The presence of carbohydrates in the feces may be due to the presence of other pathological factors, including:

• chronic pathologies small intestine, including Crohn's disease (inflammation of the gastrointestinal tract of the granulomatous type), celiac disease (lack of correct breakdown of gluten);
• secondary malabsorption of the acquired type (develops after intestinal infections, operations on the digestive tract);
• acquired insufficiency of the sucrose-isomaltase complex, which is expressed by dyspepsia (disturbance of the digestive process) after eating cereals, products with malt, starch.

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