A neonate with severe watery diarrhoea starting within days of birth is diagnosed with congenital glucose-galactose malabsorption (defective SGLT1). Which dietary modification will allow adequate calorie intake without provoking diarrhoea?

• A Substituting lactose-containing formula for standard formula
• B Replacing glucose polymers with sucrose-based feeds
• C Adding pancreatic enzyme supplements to normal milk feeds
• D Using fructose as the sole dietary carbohydrate source ✓

Explanation

SGLT1 on the apical membrane of small intestinal enterocytes cotransports glucose and galactose with sodium, and it is defective in this disorder. Fructose uses a separate apical transporter, GLUT5, which is entirely independent of SGLT1, so fructose is absorbed normally and is well tolerated. Lactose hydrolyses to glucose and galactose, and sucrose hydrolyses to glucose and fructose, so both would worsen the diarrhoea. Enzyme supplements do not bypass the transporter defect.

Reference: Nelson Textbook of Pediatrics, 22nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.