Fructose intolerance/malabsorption and recurrent abdominal pain in children.

Abstract

OBJECTIVES:

The purpose of the present study was to ascertain whether pediatric patients with chronic abdominal pain had concurrent fructose intolerance as determined by a standardized dose breath hydrogen test (BHT), and whether symptoms would improve with a low-fructose diet.

METHODS:

The fructose BHT test was administered to patients evaluated in clinic with unexplained chronic abdominal pain alone or associated with constipation, gas or bloating, and/or diarrhea. The patients were given a standard dose of 1 g/kg fructose to maximum of 25 g. Hydrogen and methane were measured at 8 time points. The test was presumed positive if breath hydrogen exceeded 20 ppm above baseline. If positive, patients were given a dietitian-prescribed low-fructose diet.

RESULTS:

A total of 222 patients were part of the study. Ages ranged from 2 to 19 years with a mean of 10.5. BHT for fructose was performed in all of the patients and it was positive for fructose intolerance in 121 of 222 patients (54.5%). A total of 101 of 222 (45.5%) patients had negative BHT for fructose intolerance. All BHT-positive patients had a nutrition consult with a registered dietitian and were placed on a low-fructose diet. Using a standard pain scale for children, 93 of 121 patients (76.9%) reported resolution of symptoms on a low-fructose diet (P < 0.0001). Furthermore, 55 of 101 patients (54.4%) with negative BHT for fructose reported resolution of symptoms without a low-fructose diet (P = 0.37).

CONCLUSIONS:

Fructose intolerance/malabsorption is common in children with recurrent/functional abdominal pain and a low-fructose diet is an effective treatment.

• Authors: Mauricio A Escobar Jr, Daniel Lustig, Bethann M Pflugeisen, Paul J Amoroso, Dalia Sherif, Rasha Saeed, Shaza Shamdeen, Judith Tuider, Bisher Abdullah
• Journal: Journal of pediatric gastroenterology and nutrition (J Pediatr Gastroenterol Nutr) Vol. 58 Issue 4 Pg. 498-501 (Apr 2014) ISSN: 1536-4801 [Electronic] United States
• PMID: 24667867 (Publication Type: Journal Article)

Chemical References

• Dietary Carbohydrates
• Fructose
• Hydrogen
• Methane

Topics

• Abdominal Pain (etiology)
• Adolescent
• Breath Tests
• Child
• Child, Preschool
• Dietary Carbohydrates (administration & dosage)
• Female
• Fructose (administration & dosage)
• Fructose Intolerance (complications, diagnosis, diet therapy)
• Humans
• Hydrogen (analysis)
• Malabsorption Syndromes (complications, diagnosis, diet therapy)
• Male
• Methane (analysis)
• Pain Measurement
• Recurrence
• Retrospective Studies
• Young Adult