Problem Ahmed L

Figure 4.22 shows the results of measuring blood glucose in a group of people after a test dose of 50 g of lactose taken at 08:30 h, before they had eaten breakfast. The two solid lines show the range of results obtained for 10 of the subjects; the dotted line marked with squares shows the results for one subject, Ahmed L.

Can you explain why Ahmed L's results were so different from the others?

About 15 minutes after the test dose of lactose, Ahmed developed severe abdominal pain and had frequent bouts of explosive watery diarrhoea, which persisted for about 2 hours. Can you account for this?

A number of papers in gastroenterological journals have reported fatal explosions during endoscopic removal of colorectal polyps using a heated wire when the gut had been prepared for surgery using an oral dose of the sugar alcohol mannitol (section 4.2.1.2) and it was insufflated with air. How does mannitol prepare the gut for surgery? What caused the explosions?

Very rarely, infants lack lactase, as a result of a genetic defect, and therefore are severely lactose intolerant. They cannot tolerate breast milk or normal infant formula, and have to be fed on special lactose-free formula.

Relatively commonly, people lose intestinal lactase in late adolescence or early o E

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