Open AccessFructose Intolerance/Malabsorption and Recurrent Abdominal Pain in Children
Author(s) -
Escobar Mauricio A.,
Lustig Daniel,
Pflugeisen Bethann M.,
Amoroso Paul J.,
Sherif Dalia,
Saeed Rasha,
Shamdeen Shaza,
Tuider Judith,
Abdullah Bisher
Publication year - 2014
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000000232
Subject(s) - medicine , fructose , gastroenterology , abdominal pain , bloating , hydrogen breath test , malabsorption , constipation , breath test , food science , chemistry , helicobacter pylori
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.