scholarly journals Roles of Lactose and Fructose Malabsorption and Dietary Outcomes in Children Presenting with Chronic Abdominal Pain

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 3063 ◽  
Author(s):  
Carsten Posovszky ◽  
Vreni Roesler ◽  
Sebastian Becker ◽  
Enno Iven ◽  
Christian Hudert ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Incidental Finding ◽  
Elimination Diet ◽  
Chronic Abdominal Pain ◽  
Functional Abdominal Pain ◽  
Lactose Malabsorption ◽  
Carbohydrate Malabsorption ◽  
Fructose Malabsorption ◽  
Hydrogen Breath Tests ◽  
Carbohydrate Intolerance

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.

scholarly journals Gallbladder motility in children with chronic functional abdominal pain

2019 ◽  
Vol 6 (5) ◽  
pp. 2042
Author(s):  
Raaghul C. ◽  
Rajesh N. T. ◽  
Vikrant Kanagaraju ◽  
Bharathi Elangovan
Keyword(s):  
Abdominal Pain ◽  
Ejection Fraction ◽  
Gall Bladder ◽  
Chronic Abdominal Pain ◽  
Gallbladder Motility ◽  
P Value ◽  
Functional Abdominal Pain ◽  
Rome Iii ◽  
The Mean ◽  
Upper Abdominal

Background: Chronic abdominal pain is a common gastrointestinal symptom in children that significantly lowers their quality of life. In adults, Gall bladder (GB) hypomotility / dyskinesia is associated with many functional abdominal disorders but there is scarcity of evidence on its role in childhood gastro-intestinal disorders. Aim of the study is to evaluate the GB motility in children with chronic functional abdominal pain (FAP).Methods: Children aged 5-15 years with chronic abdominal pain fulfilling ROME-III criteria and healthy controls were included and all study participants were subjected to ultrasonographic evaluation of the gall bladder volume in fasting state and post - Fatty test meal (FTM) and its ejection fraction was calculated.Results: Sixtysix children including 31 with chronic FAP underwent sonographic evaluation for GB motility. The mean ejection fraction (EF) of cases and controls were 51.72±17.76% and 57.3±23.26% (p value - 0.158). The mean EF of cases with upper abdominal pain and lower/peri-umbilical abdominal pain were 41.7±17.1% and 57.2±15.9% respectively (p value < 0.0001). Increasing BMI had no significant association with GB motility among the participants.Conclusions: There is lack of significant association between children with chronic FAP and GB hypomotility. Children with upper abdominal pain have lesser GB EF, suggesting a possible abnormal GB motility.

scholarly journals FRUCTOSE MALABSORPTION IN CHILDREN WITH FUNCTIONAL DIGESTIVE DISORDERS

2013 ◽  
Vol 50 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Adriana Chebar LOZINSKY ◽  
Cristiane BOE ◽  
Ricardo PALMERO ◽  
Ulysses FAGUNDES-NETO
Keyword(s):  
Aqueous Solution ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Breath Test ◽  
Gastrointestinal Symptoms ◽  
Functional Abdominal Pain ◽  
Hydrogen Breath Test ◽  
Fasting Level ◽  
Fructose Malabsorption ◽  
Irritable Bowel

Context Fructose is a monosaccharide frequently present in natural and artificial juice fruits. When the concentration of fructose in certain food is present in excess of glucose concentration some individuals may develop fructose malabsorption. Objectives To report the frequency of fructose malabsorption utilizing the hydrogen breath test in children with gastrointestinal and/or nutritional disorders. Methods Between July 2011 and July 2012, 43 patients with gastrointestinal and/or nutritional disorders, from both sexes, were consecutively studied, utilizing the hydrogen breath test with loads of the following carbohydrates: lactose, glucose, fructose and lactulose. Fructose was offered in a 10% aqueous solution in the dose of 1 g/kg body weight. Samples were collected fasting and at every 15 minutes after the intake of the aqueous solution for a 2 hour period. Malabsorption was considered when there was an increase of >20 ppm of hydrogen over the fasting level, and intolerance was diagnosed if gastrointestinal symptoms would appear. Results The age of the patients varied from 3 months to 16 years, 24 were boys. The following diagnosis were established: irritable bowel syndrome with diarrhea in 16, functional abdominal pain in 8, short stature in 10, lactose intolerance in 3, celiac disease in 1, food allergy in 1 and giardiasis in 1 patient. Fructose malabsorption was characterized in 13 (30.2%) patients, and intolerance in 1 (2.3%) patient. The most frequent fructose malabsorption was characterized in 7 (16.3%) patients with irritable bowel syndrome and in 4 (9.3%) patients with functional abdominal pain. Conclusions Patients with irritable bowel syndrome and functional abdominal pain were the main cause of fructose malabsorption.

scholarly journals Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Dietmar Enko ◽  
Andreas Meinitzer ◽  
Harald Mangge ◽  
Gernot Kriegshäuser ◽  
Gabriele Halwachs-Baumann ◽  
...  
Keyword(s):  
Diamine Oxidase ◽  
Abdominal Discomfort ◽  
Dietary Advice ◽  
Lactose Malabsorption ◽  
Carbohydrate Malabsorption ◽  
Fructose Malabsorption ◽  
Gi Symptoms ◽  
Diamine Oxidase Activity ◽  
Diagnostic Work ◽  
Low Serum

The aim of this retrospective study was to analyze the concomitant prevalence rates for lactose malabsorption (LM), fructose malabsorption (FM), and histamine intolerance (HI) in patients with so far unexplained gastrointestinal (GI) symptoms. A total of 439 outpatients, who presented unclear abdominal discomfort, underwent lactose (50 g) and fructose (25 g) hydrogen (H2) breath tests. Additionally, serum diamine oxidase (DAO) measurements were performed. Individuals with low serum DAO activity (<10 U/mL), GI symptoms, and response to histamine-free diet were diagnosed with HI. Of all 439 patients, 341 (77.7%) were found with 7 various GI conditions. In total, 94 (21.4%), 31 (7.1%), and 100 (22.8%) individuals presented LM, FM, or HI only, whereas 116 (26.4%) patients showed an overlap of GI entities investigated here. Interestingly, 89 out of 241 (36.9%) individuals with carbohydrate malabsorption were also diagnosed with HI (LM + HI: 52 [11.8%], FM + HI: 23 [5.2%], and LM + FM + HI 14 [3.2%] individuals). In conclusion different combinations of LM, FM, and HI are present in individuals with unclear abdominal discomfort/pain. In clinical practice we suggest testing for LM, FM, and additional HI in the diagnostic work-up of these patients. Depending on these various diagnoses possible, patients should get an individualized dietary advice.

scholarly journals FUNCTIONAL PAIN ABDOMEN IN CHILDREN: EPIDEMIOLOGY AND ETIOPATHOLOGY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Shaitan Singh Balai
Keyword(s):  
Abdominal Pain ◽  
Female Gender ◽  
Chronic Abdominal Pain ◽  
Lower Socioeconomic Status ◽  
Functional Abdominal Pain ◽  
Pain Abdomen ◽  
Lower Socioeconomic ◽  
Functional Pain ◽  
Prevalence Of Pain ◽  
Control Study

Background: Chronic abdominal pain is one of the most common problem dealt in day to day practice by paediatricians. In most of these children, no cause can be identified. Although it is common but its definition, pathophysiological mechanisms and predisposing factors are not completely understood & there is need for large well performed clinical trials for evidence based treatment. Methods: Hospital based prospective case control study conducted on 100 children aged 5 to 15 years in routine OPD and indoor patient fulfilling the inclusion criteria.   Conclusion: Female gender, school going children, psychological stress, traumatic life event and lower socioeconomic status increase the prevalence of pain abdomen in children. Keywords: Functional abdominal pain (FAP), Chronic abdominal pain. Children

Prevalence of carbohydrate malabsorption in children with various functional abdominal pain disorders

2020 ◽  
Vol 10 (2) ◽  
pp. 11-15
Author(s):  
A.V. Naletov ◽  
◽  
D.A. Karpenko ◽  
N.P. Guz ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Functional Abdominal Pain ◽  
Carbohydrate Malabsorption

Fructose malabsorption in asymptomatic children and in patients with functional chronic abdominal pain: a prospective comparative study

2019 ◽  
Vol 178 (9) ◽  
pp. 1395-1403 ◽  
Author(s):  
Oihana Martínez-Azcona ◽  
Ana Moreno-Álvarez ◽  
Teresa Seoane-Pillado ◽  
Inés Niño-Grueiro ◽  
Ana Ramiro-Comesaña ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Comparative Study ◽  
Chronic Abdominal Pain ◽  
Fructose Malabsorption ◽  
Asymptomatic Children ◽  
Prospective Comparative Study

scholarly journals FUNCTIONAL PAIN ABDOMEN IN CHILDREN

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Abhilasha Smith ◽  
Sandhya Lata
Keyword(s):  
Abdominal Pain ◽  
Female Gender ◽  
Recurrent Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Functional Abdominal Pain ◽  
Pain Abdomen ◽  
Lower Socioeconomic ◽  
Increased Risk ◽  
Group 5 ◽  
Upper Abdomen

Background: Chronic abdominal pain is one of the most common problem dealt in day to day practice by paediatricians. In most of these children, no cause can be identified. Although it is common but its definition, pathophysiological mechanisms and predisposing factors are not completely understood & there is need for large well performed clinical trials for evidence based treatment. Methods: Hospital based prospective case control study conducted at Department of Paediatric. The study was commenced after obtaining clearance from institutional ethical committee. Written consent were taken from the parents for this study and those who were not willing excluded from study. Patients of age group 5 to 15 yrs of any gender presenting to paediatrics hospital (who fulfill inclusion and exclusion criteria) with >3 episodes of abdominal pain in preceding year were enrolled for study. Results: Most common site of pain was upper abdomen present in 72% children, followed by lower abdomen in 22% children and generalized pain abdomen in 8% children. Prevalence of functional GI Disorders in children with RAP. 92% children had FGIDs while rest 8% children had organic or infectious aetiology. Conclusion: This study reports higher prevalence of FGIDs in children with RAP and also identifies the variables associated with increased risk of this disorder in children with RAP. Female gender, school going children, psychological stress, traumatic life event and lower socioeconomic status increase the prevalence. Keywords: Recurrent abdominal pain (RAP), Functional abdominal pain (FAP), Chronic abdominal pain.

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