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标题：Roles of Lactose and Fructose Malabsorption and Dietary Outcomes in Children Presenting with Chronic Abdominal Pain
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作者：Carsten Posovszky ,, , Vreni Roesler , , Sebastian Becker , Enno Iven , Christian Hudert , Friedrich Ebinger , Claudia Calvano ; Petra Warschburger
期刊名称：Nutrients
电子版ISSN：2072-6643
出版年度：2019
卷号：11
期号：12
页码：1-9
DOI：10.3390/nu11123063
出版社：MDPI Publishing
摘要：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.
关键词：chronic abdominal pain; children; fructose malabsorption; lactose intolerance; hydrogen breath test; functional abdominal pain disorders chronic abdominal pain ; children ; fructose malabsorption ; lactose intolerance ; hydrogen breath test ; functional abdominal pain disorders