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Relationships between disaccharidase deficiencies, duodenal inflammation and symptom profile in children with
Jennifer M Colombo1, Chance S Friesen1, Uttam Garg2
1Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64109, USA.
Insights
Disaccharidase deficiencies, common in youth with abdominal pain, are not predictable by symptoms. Further research is needed to understand the clinical significance of these common digestive enzyme deficiencies.
Area of Science:
- Gastroenterology
- Digestive Physiology
- Clinical Nutrition
Background:
- Abdominal pain is frequently linked to disaccharidase deficiencies.
- Previous research has explored individual symptoms but not symptom complexes or inflammation in relation to these deficiencies.
Purpose of the Study:
- To investigate the relationship between disaccharidase deficiencies and specific symptoms or symptom complexes.
- To assess the association between disaccharidase deficiencies and duodenal inflammation.
Main Methods:
- Patients with abdominal pain undergoing endoscopy and disaccharidase activity testing were identified.
- Exclusion criteria included inflammatory bowel disease, celiac disease, H. pylori, and significant endoscopic lesions.
- Disaccharidase deficiency frequency was determined and compared between patients with and without histologic duodenitis; symptom associations were also evaluated.
Main Results:
- Lactase deficiency occurred in 34.3% of patients; 7.6% had multiple disaccharidase deficiencies.
- No individual symptoms or symptom complexes reliably predicted disaccharidase deficiency.
- Duodenitis was not significantly associated with disaccharidase deficiency, though its prevalence was low (5.9%).
Conclusions:
- Disaccharidase deficiency, especially lactase deficiency, is prevalent in pediatric patients experiencing abdominal pain.
- Symptoms do not predict disaccharidase deficiency in this population.
- Further studies are required to elucidate the clinical implications of disaccharidase deficiencies.
Abstract:
Abdominal pain has been associated with disaccharidase deficiencies. While relationships with individual symptoms have been assessed, relationships between disaccharidase deficiencies and symptom complexes or inflammation have not been evaluated in this group. The primary aims of the current study were to assess relationships between disaccharidase deficiency and symptoms or symptom complexes and duodenal inflammation, respectively. Patients with abdominal pain who underwent endoscopy with evaluation of disaccharidase activity levels were identified. After excluding all patients with inflammatory bowel disease, celiac disease, H. pylori, or gross endoscopic lesions, patients were evaluated for disaccharidase deficiency frequency. Disaccharidase were compared between patients with and without histologic duodenitis. Lastly, relationships between individual gastrointestinal symptoms or symptom complexes were evaluated. Lactase deficiency was found in 34.3% of patients and disaccharidase pan-deficiency in 7.6%. No individual symptoms or symptom complexes predicted disaccharidase deficiency. While duodenitis was not associated with disaccharidase deficiency, it was only present in 5.9% of patients. Disaccharidase deficiency, particularly lactase deficiency, is common in youth with abdominal pain and multiple deficiencies are not uncommon. Disaccharidase deficiency cannot be predicted by symptoms in this population. Further studies are needed to assess the clinical significance of disaccharidase deficiency.
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