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Lactose Breath Test in Children: Relationship Between Symptoms During the Test and Test Results
Miguel Glatstein1,2, Shimon Reif3, Dennis Scolnik4
1Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children Hospital, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Diarrhea and flatulence during a hydrogen breath test (HBT) strongly indicate lactose intolerance. Abdominal pain is less specific, even with lactose malabsorption. Real-time symptom tracking improves HBT interpretation.
Area of Science:
- Pediatric Gastroenterology
- Clinical Diagnostics
Background:
- Lactose malabsorption impacts 70% of the global population.
- The hydrogen breath test (HBT) is a standard clinical tool for diagnosing lactose malabsorption.
- Understanding symptom correlation with HBT results is crucial for accurate diagnosis.
Purpose of the Study:
- To investigate the relationship between symptoms experienced before and during the HBT and the test outcomes.
- To identify specific symptoms indicative of lactose intolerance.
- To assess the utility of real-time symptom questionnaires in HBT interpretation.
Main Methods:
- A 6-month prospective study involving children undergoing HBT at a pediatric gastroenterology unit.
- Symptom assessment using questionnaires and a validated pain scale before and after the HBT.
- Analysis of 95 pediatric patients' HBT results and reported symptoms.
Main Results:
- 66.3% of the 95 children studied had a positive HBT.
- Diarrhea and flatulence during the HBT were significantly more common in children with positive results (P=0.016 and P=0.006, respectively).
- Abdominal pain and bloating frequencies did not significantly differ between positive and negative HBT groups.
Conclusions:
- Diarrhea and flatulence during HBT are highly specific indicators of lactose intolerance.
- Abdominal pain is not a definitive symptom of lactose intolerance, even with confirmed malabsorption.
- Integrating real-time symptom questionnaires with HBT enhances diagnostic accuracy and treatment recommendations.
Background:
Lactose malabsorption affects 70% of the world population. The hydrogen breath test (HBT) is used clinically to test for this condition. The aim of our study was to describe the relationship between symptoms experienced before and during the HBT and test results.
Methods:
We included children who underwent the HBT in the pediatric gastroenterology unit at Dana-Dwek Children's Hospital during a 6-month period. Previous symptoms and those experienced before and after the HBT were assessed using a questionnaire and a validated pain scale.
Results:
Ninety-five children were included in the study, and 66.3% had a positive HBT. Diarrhea and flatulence during the test were significantly more frequent in the group with a positive HBT compared to those with a negative test (31.7% vs. 9.4%, P = 0.016 and 69.8% vs. 40.6%, P = 0.006, respectively). The frequency of abdominal pain and bloating was similar.
Conclusions:
Diarrhea and flatulence during the HBT are the most specific symptoms of lactose intolerance. Abdominal pain should not be automatically attributed to lactose intolerance even in the presence of lactose malabsorption. Coupling the HBT with a real-time questionnaire facilitates interpretation of results and subsequent recommendations.
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