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Cancer chemotherapy-induced lactose malabsorption in children
Insights
Cancer chemotherapy can induce lactose malabsorption in children, leading to digestive issues like diarrhea. A low lactose diet may help manage these symptoms during treatment.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Nutritional Science
Background:
- Cancer chemotherapy regimens can significantly impact a child's gastrointestinal health.
- Lactose malabsorption is a common issue, but its induction by chemotherapy in pediatric cancer patients is not well-established.
Purpose of the Study:
- To investigate the potential for cancer chemotherapy to induce lactose malabsorption in pediatric patients.
- To assess the prevalence of lactose malabsorption following chemotherapy in children with neoplastic diseases.
Main Methods:
- Lactose breath hydrogen tests (LBHT) were administered to 27 pediatric cancer patients.
- Tests were conducted before and after chemotherapy initiation in one group, and after the final course in another group of younger children.
Main Results:
- Three out of nine patients showed induced lactose malabsorption after chemotherapy initiation.
- Six out of eighteen younger patients (under 5 years) exhibited abnormal LBHT results after their last chemotherapy course.
- A history of diarrhea was reported in six of the nine patients with abnormal LBHT results.
Conclusions:
- Cancer chemotherapy can induce lactose malabsorption in children.
- Clinical manifestations like diarrhea may be linked to chemotherapy-induced lactose malabsorption.
- Nutritional support containing lactose may exacerbate gastrointestinal distress; a low lactose diet trial is suggested for symptomatic patients.
Abstract:
To determine whether lactose malabsorption can be induced in children receiving cancer chemotherapy, lactose breath hydrogen tests (LBHT) were performed on 27 patients (ages 2 months to 16 10/12 years, mean 4 3/12 years) with neoplastic disease. Nine patients had an LBHT before their first course of chemotherapy and then 7--26 days afterwards. Eighteen other patients, less than 5 years old and presumed by virtue of age to be normal lactose absorbers, had an LBHT 7--24 days after their last course of chemotherapy. All nine in the first group had a normal LBHT before chemotherapy, and three had an abnormal LBHT 7--21 days later. Six of eighteen patients in the second group had an abnormal LBHT. Of the nine patients with an abnormal LBHT, six had a history of diarrhea associated with chemotherapy. These findings have important implications for children receiving cancer chemotherapy. High-calorie, milk-containing solutions used in nutritional support may precipitate cramps and diarrhea in some of these patients. A therapeutic trial of a low lactose diet in children in whom diarrhea develops during chemotherapy may be indicated.