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Area of Science:

  • Pediatric Gastroenterology
  • Nutritional Science
  • Diagnostic Medicine

Background:

  • Fructose, a common monosaccharide in fruits and sweeteners, can cause malabsorption when its concentration exceeds glucose.
  • Fructose malabsorption occurs when the small intestine cannot adequately absorb fructose, leading to gastrointestinal symptoms.
  • This condition is often associated with underlying gastrointestinal or nutritional disorders in children.

Purpose of the Study:

  • To determine the prevalence of fructose malabsorption in children experiencing gastrointestinal and/or nutritional problems.
  • To utilize the hydrogen breath test as a diagnostic tool for fructose malabsorption in a pediatric cohort.
  • To identify potential correlations between fructose malabsorption and specific pediatric gastrointestinal disorders.

Main Methods:

  • A cohort of 43 children (3 months to 16 years) with gastrointestinal/nutritional disorders were enrolled between July 2011 and July 2012.
  • The hydrogen breath test was administered using lactose, glucose, fructose, and lactulose challenges.
  • Fructose malabsorption was diagnosed by a >20 ppm increase in breath hydrogen over fasting levels post-ingestion of a 1 g/kg fructose solution.

Main Results:

  • Fructose malabsorption was identified in 13 out of 43 patients (30.2%).
  • Fructose intolerance, marked by symptoms, was observed in 1 patient (2.3%).
  • The highest rates of fructose malabsorption were found in patients with irritable bowel syndrome (16.3%) and functional abdominal pain (9.3%).

Conclusions:

  • Irritable bowel syndrome and functional abdominal pain are significant contributing factors to fructose malabsorption in children.
  • The hydrogen breath test is an effective method for diagnosing fructose malabsorption in pediatric patients with digestive complaints.
  • Early identification and management of fructose malabsorption can improve outcomes for children with gastrointestinal disorders.