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Lactase deficiency among Malaysian children with recurrent abdominal pain
1Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. boeycm@medicine.med.um.edu.my
Insights
Lactase deficiency is common in Malaysian children with recurrent abdominal pain, affecting over 70%. However, this deficiency did not seem to be the cause of their pain symptoms.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
Background:
- Recurrent abdominal pain (RAP) is a common pediatric complaint.
- Lactase deficiency, the inability to digest lactose, is prevalent in many Asian populations.
Purpose of the Study:
- To determine the prevalence of lactase deficiency in Malaysian children experiencing recurrent abdominal pain.
- To describe the clinical characteristics associated with lactase deficiency in this cohort.
Main Methods:
- Twenty-four children meeting Apley's criteria for RAP were enrolled.
- Lactase deficiency was assessed using a hydrogen breath test.
- Lactulose challenge was used to confirm hydrogen-producing capacity.
Main Results:
- A high prevalence of lactase deficiency was observed, with 70.8% of children testing positive.
- Prevalence varied by ethnicity: 100% in Indian, 71.4% in Chinese, and 40% in Malay children.
- No significant differences in clinical features or symptom improvement on a lactose-free diet were found between lactase-sufficient and deficient groups.
Conclusions:
- Lactase deficiency is highly prevalent in Malaysian children with recurrent abdominal pain.
- Despite the high prevalence, lactase deficiency did not appear to be a significant causative factor for the abdominal pain in this study population.
Objectives:
To determine the prevalence of lactase deficiency among Malaysian children with recurrent abdominal pain and to describe their clinical characteristics.
Methodology:
Twenty-four children referred consecutively to the University of Malaya Medical Centre who fulfilled Apley's criteria (at least three episodes of abdominal pain severe enough to affect normal activity over a period longer than 3 months) were tested for lactase deficiency using a pocket breath test analyser (BreatH2 meter; Europa Scientific, Cheshire, England). Lactulose was used to check for hydrogen-producing capacity.
Results:
There were 14 males and 10 females in the study, consisting of five Malays, 14 Chinese and five Indians. Mean age was 9.9 years. Seventeen of the 24 children (70.8%) with recurrent abdominal pain who underwent the breath hydrogen test had a positive result. In those with a negative result, subsequent lactulose administration resulted in a positive rise in breath hydrogen. None of the 24 children developed abdominal pain during the test. All the Indian subjects, 71.4% of the Chinese subjects and 40% of the Malay subjects with recurrent abdominal pain had lactase deficiency. The proportion of boys and girls with lactase deficiency was similar (71.4 vs 70.0%, respectively). There was no significant difference between lactase sufficient and deficient children with recurrent abdominal pain with regard to sex, age, ethnic group and clinical features. Following a lactose-free diet, none of the children in the breath hydrogen positive and negative groups reported any appreciable difference in pain symptoms.
Conclusions:
The prevalence of lactase deficiency among this group of Malaysian children with recurrent abdominal pain was high, but lactase deficiency did not appear to play an important role in causing the symptoms.