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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.
Listening to the heart
(2019)
Objective: The affective-reflective theory of physical inactivity and exercise suggests that the mere thought of exercise can lead to an immediate somato-affective response which, if negative, will drive a physically inactive person to maintain his or her current exercise-avoidant behavior. This study aimed to test the assumption that the somatic core of this affective response can be identified by means of heart rate variability (HRV) analysis. Design: This study followed a within-subject experimental design. Method. Participants were 91 adult men and women whose HR and HRV were monitored whilst they viewed exercise-related and control pictures in a laboratory setting. Results: Analyses revealed a decrease in HRV during the viewing of exercise-related pictures in less physically active participants. These participants reported that the same pictures elicited feelings with relatively low affective valence and arousal. There were no changes in HR.
On being and belonging
(2019)