TY  - JOUR
A1  - Posovszky, Carsten
A1  - Roesler, Vreni Helen
A1  - Becker, Sebastian
A1  - Iven, Enno
A1  - Hudert, Christian
A1  - Ebinger, Friedrich
A1  - Calvano, Claudia
A1  - Warschburger, Petra
T1  - Roles of Lactose and Fructose Malabsorption and Dietary Outcomes in Children Presenting with Chronic Abdominal Pain
JF  - Nutrients
N2  - Intolerance to lactose or fructose is frequently diagnosed in children with chronic abdominal pain (CAP). However, the causal relationship remains a matter of discussion. A cohort of 253 patients, aged 7-12 years, presenting with unexplained CAP received standardized diagnostics. Additional diagnostic tests were performed based on their medical history and physical and laboratory investigations. Fructose and lactose hydrogen breath tests (H2BT) as well as empiric diagnostic elimination diets were performed in 135 patients reporting abdominal pain related to the consumption of lactose or fructose to evaluate carbohydrate intolerance as a potential cause of CAP. Carbohydrate malabsorption by H2BT was found in 55 (41%) out of 135 patients. An abnormal increase in H2BT was revealed in 30% (35/118) of patients after fructose consumption and in 18% (20/114) of patients after lactose administration. Forty-six percent (25/54) reported pain relief during a diagnostic elimination diet. In total, 17 patients had lactose malabsorption, 29 fructose malabsorption, and nine combined carbohydrate malabsorption. Carbohydrate intolerance as a cause of CAP was diagnosed at follow-up in only 18% (10/55) of patients with malabsorption after the elimination of the respective carbohydrate. Thus, carbohydrate malabsorption appears to be an incidental finding in children with functional abdominal pain disorders, rather than its cause. Therefore, testing of carbohydrate intolerance should only be considered in children with a strong clinical suspicion and with the goal to prevent long-term unnecessary dietary restrictions in children suffering from CAP.
KW  - chronic abdominal pain
KW  - children
KW  - fructose malabsorption
KW  - lactose intolerance
KW  - hydrogen breath test
KW  - functional abdominal pain disorders
Y1  - 2019
U6  - https://doi.org/10.3390/nu11123063
SN  - 2072-6643
VL  - 11
IS  - 12
PB  - MDPI
CY  - Basel
ER  -