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Selective lactase deficiency is common in pediatric patients undergoing upper endoscopy

Annie Goodwin1, Lina Karam1, G S Gopalakrishna1

  • 1Section of Pediatric Gastroenterology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Journal of Molecular Biochemistry
|April 30, 2019
PubMed

Insights

Lactase deficiency is common in children undergoing endoscopy, affecting 39% of patients. This study found no increased rate in those with inflammatory bowel disease (IBD).

Area of Science:

  • Pediatric Gastroenterology
  • Digestive Health
  • Clinical Nutrition

Background:

  • Lactase deficiency causes significant symptoms in children.
  • Limited research exists on enzyme testing for disaccharidase deficiencies (DDs) in pediatric endoscopy.
  • Prevalence of DDs in pediatric patients with and without inflammatory bowel disease (IBD) is not well-established.

Purpose of the Study:

  • To determine the prevalence of lactase and other DDs in pediatric patients undergoing upper endoscopy.
  • To compare the prevalence of DDs in children with and without IBD.
  • To identify factors associated with lactase deficiency in this population.

Main Methods:

  • Chart review of 739 pediatric patients (ages 1-18) undergoing esophago-gastro-duodenoscopy (EGD).
  • Analysis of 560 patients who underwent mucosal enzyme testing during EGD.
  • Comparison of DD prevalence between IBD and non-IBD groups, and analysis of age and race correlations.

Main Results:

  • Overall lactase deficiency (LD) rate was 39%, increasing with age.
  • No significant difference in LD between IBD (45%) and non-IBD (42%) patients.
  • Four patients (0.17%) had selective maltase deficiency; none had sucrase or palatinase deficiency. Significant racial differences in LD were observed.

Conclusions:

  • Lactase deficiency is common in children undergoing EGD.
  • The rate of LD is not elevated in pediatric IBD patients.
  • Disaccharidase testing should be considered during EGD in children.

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