1. Carbohydrate digestion

2. You should know:  Starch, the role of salivary and pancreatic amylases and of maltase located in the  intestinal epithelium Disaccharides, sucrase and lactase. Lactose intolerance

4. What sort of sugar is the monomer for starch? What type of bond links the sugar molecules? What is the name of this molecule?

5. Stages in carbohydrate digestion  (i)In the mouth  Starch → maltose via enzyme amylase.  Stomach acidic pH 2 which denatures amylase.  pancreatic amylase which continues hydrolysis of starch → maltose.  Maltase in epithelial lining of small intestine. Maltose → α glucose

6. Disaccharide digestion  Epithelial cells in lining of small intestine produce enzyme sucrase. Sucrose (disaccharide) → glucose + fructose (2 monosaccharides).  Epithelial lining produce enzyme lactase. Lactose (disaccharide) → glucose + galactose (2 monosaccharides

7. Lactose Intolerance  Babies produce lots of lactase. Amount diminishes as we get older.  Lactase is found in the microvilli of the epithelial cells lining the small intestine.  Some people produce little or no lactase.  Nowadays we eat lots of milk products. Some cannot digest it all.  Undigested lactose reaches the large intestine where micro-organisms break it down and produce loads of gas.  Result = bloating, nausea, diarrhoea and cramps.  Lactose intolerant individuals need to avoid foods with lactose in them.

8. Causes of lactose intolerance  Primary Usually inherited = fault in gene that codes for lactase production.  Secondary Person can’t produce enough lactase due to damage to small intestine through injury or disease. E.g. coeliac disease, inflammatory bowel disease or Crohn’s diseases.

9. Tests for lactose intolerance  Patient fasts before test.  Then drink a lactose sample.  A blood sample is taken every 2 hours and the level of glucose in the blood is measured.  If lactose is being broken down, then glucose level should rise. If intolerant, then will stay low.

10. Hydrogen breath test  Patient drinks fluid containing lactose. Patients breath measured for hydrogen.  Normal breath has little.  If lactose intolerant then will have higher levels because bacteria in large intestine are digesting the lactose and producing large amounts of hydrogen.

11. Stool Acidity test  Measure level of acidity in stools. If lactose intolerant then fermented in large intestine by bacteria to produce lactic acid and other fatty acids.