No one would doubt the fact that the number of patients seeking help for carbohydrate malabsorption problems has substantially risen over recent years. When asked, many patients express the opinion that they have an intolerance to fructose, whereas just a few questions regarding clinical symptoms will clarify that what actually affects them is a far more harmless fructose resorption disorder. The authors explicitly caution in their article (1) that “gastrointestinal malabsorption of fructose should not be confused with hereditary fructose intolerance.” But the term “gastrointestinal carbohydrate intolerance,” as used in the abstract, does not exactly help clarify matters.
The tables and figures show substantial gaps and errors when mentioning congenital defects in the monosaccharide metabolism, and these defects do not in any case relate symptomatically to malabsorptions in terms of the differential diagnosis. Although “galactosemia” refers to three congenital defects, galactokinase deficiency is the only one listed. This is a defect common in persons of Sinti/Romany origin and manifests as cataract development. The only embarrassing thing is that since 2002, all neonates in Germany are examined for another type of galactosemia: galactose 1 phosphate uridyltransferase deficiency, the so called classic galactosemia. It would be highly desirable for this information, or a correction, to be added to this article post hoc.
Prof. Dr. med. Eberhard Mönch
Conflict of interest statement
Professor Mönch has received honoraria for co-authoring a publication relating to the topic under discussion.
|1.||Raithel M, Weidenhiller M, Hagel AFK, Hetterich U, Neurath MFK, Konturek PC: The malabsorption of commonly occurring mono- and disaccharides—levels of investigation and differential diagnosis. Dtsch Aerztebl Int 2013; 110(46): 775–82 VOLLTEXT|