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Functional Abdominal Pain Disorders in Children May Be Associated with Food Intolerance/Malabsorption

Wolfgang J Schnedl1,2, Michael Schenk3, Simon Michaelis4

  • 1Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria.

Children (Basel, Switzerland)
|September 28, 2023
PubMed

Insights

Functional abdominal pain disorders in children are often linked to food intolerances. This study found that investigating lactose intolerance, histamine intolerance, and fructose malabsorption can identify underlying causes in pediatric patients with FAPDs.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Immunology

Background:

  • Functional abdominal pain disorders (FAPDs) are common in children, presenting with chronic abdominal pain and altered bowel habits.
  • The exact pathophysiology of FAPDs remains unclear, but potential links to food intolerance and malabsorption exist.
  • Current diagnostic approaches for FAPDs in pediatric populations require further refinement.

Purpose of the Study:

  • To investigate the prevalence of food intolerance and malabsorption in children diagnosed with FAPDs.
  • To evaluate a personalized diagnostic approach for identifying specific food intolerances in pediatric FAPDs.
  • To establish a link between FAPDs and conditions like lactose intolerance, histamine intolerance, and fructose malabsorption.

Main Methods:

  • Retrospective analysis of 51 pediatric patients with FAPDs investigated between 2017 and 2022.
  • Utilized small intestinal biopsies, hydrogen breath tests (for lactose and fructose malabsorption), serum diamine oxidase (DAO) levels (for histamine intolerance), and celiac disease antibody screening.
  • Included IgA antibody testing for *H. pylori* infection.

Main Results:

  • All 51 children were diagnosed with at least one food intolerance or malabsorption condition.
  • Prevalence included fructose malabsorption (n=7), histamine intolerance (n=8), and lactose intolerance (n=8).
  • Significant overlap was observed, with combinations of intolerances found in 70% of patients, including triple combinations.

Conclusions:

  • Functional abdominal pain disorders in children are frequently associated with identifiable food intolerances and malabsorption.
  • A personalized, multi-faceted diagnostic strategy effectively identifies these underlying conditions in pediatric FAPDs.
  • Dietary modifications, guided by a registered dietitian, are crucial for managing FAPDs once food intolerances are diagnosed.

Keywords:
fructose malabsorptionfunctional abdominal pain disordershistamine intoleranceirritable bowel syndromelactose intolerance

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