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Carbohydrate malabsorption following fruit juice ingestion in young children
J S Hyams1, N L Etienne, A M Leichtner
1Department of Pediatrics, Hartford Hospital, Connecticut 06115.
Insights
Fruit juices containing sorbitol can cause carbohydrate malabsorption in children, leading to symptoms like diarrhea. Breath hydrogen tests revealed significant malabsorption with pear and apple juices, and some cases with grape juice.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Digestive Health
Background:
- Chronic nonspecific diarrhea is common in children.
- Fruit juices are frequently consumed by children.
- Sorbitol is a common ingredient in some fruit juices and can cause gastrointestinal upset.
Purpose of the Study:
- To investigate carbohydrate malabsorption in children after ingesting fruit juices and sorbitol.
- To assess the association between breath hydrogen excretion and gastrointestinal symptoms.
- To compare malabsorption in healthy children versus those with chronic nonspecific diarrhea.
Main Methods:
- Breath hydrogen analyses were performed on healthy children and children with chronic nonspecific diarrhea.
- Subjects ingested pear, grape, and apple juices, and a 2% sorbitol solution.
- Excess breath hydrogen excretion was measured as an indicator of carbohydrate malabsorption.
Main Results:
- Virtually all subjects showed excess breath hydrogen after pear juice (2% sorbitol) and 2% sorbitol solution.
- Approximately 50% of subjects showed malabsorption with apple juice (0.5% sorbitol), and 25% with grape juice (no sorbitol).
- Forty percent of subjects with excess hydrogen excretion reported diarrhea and abdominal cramping; no significant differences were observed between healthy children and those with diarrhea.
Conclusions:
- Carbohydrate malabsorption is frequent in children after consuming common fruit juices, particularly those containing sorbitol.
- Sorbitol malabsorption from fruit juices may contribute to nonspecific gastrointestinal symptoms in some children.
- Breath hydrogen testing is a useful tool for diagnosing carbohydrate malabsorption in pediatric populations.
Abstract:
We performed breath hydrogen analyses in 13 healthy children (9 to 36 months of age) and seven children (14 to 27 months of age) with chronic nonspecific diarrhea after they had ingested pear, grape, and apple juices and a 2% sorbitol solution. Excess breath H2 excretion was found in virtually all study subjects following the ingestion of either pear juice (with approximately 2% sorbitol content) or the 2% sorbitol solution, in approximately 50% of those ingesting apple juice (0.5% sorbitol), and in 25% of those ingesting grape juice (no sorbitol) (P less than .001, analysis of variance). No differences were noted between the healthy children and those with chronic nonspecific diarrhea. Forty percent of all study subjects in whom excess breath hydrogen excretion occurred also had diarrhea and abdominal cramping. Carbohydrate malabsorption appears to be frequent following the ingestion of common fruit juices and in some children may be associated with nonspecific gastrointestinal symptoms.