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Lactose malabsorption in recurrent abdominal pain of childhood
Insights
Lactose malabsorption is uncommon in children with recurrent abdominal pain (RAP). Dietary changes showed no significant difference in symptom improvement between children who malabsorbed lactose and those who did not.
Area of Science:
- Pediatric Gastroenterology
- Digestive Health
- Clinical Nutrition
Background:
- Recurrent abdominal pain (RAP) is a common pediatric condition.
- The role of lactose malabsorption in pediatric RAP remains unclear.
- Accurate diagnosis of lactose malabsorption is crucial for effective management.
Purpose of the Study:
- To evaluate the significance of lactose malabsorption in children experiencing recurrent abdominal pain.
- To determine if lactose malabsorption contributes to the symptoms of pediatric RAP.
Main Methods:
- A prospective, controlled, double-blinded study was conducted on 40 children with RAP.
- Lactose malabsorption was assessed using breath hydrogen tests after lactose ingestion.
- Children underwent a dietary trial involving lactose elimination periods.
Main Results:
- 30% of children were identified as lactose malabsorbers.
- Only a small subset of malabsorbers showed symptoms with a smaller lactose load.
- No significant difference in symptom improvement was observed between malabsorbers and absorbers during lactose elimination.
Conclusions:
- Lactose malabsorption appears to play a minor role in pediatric recurrent abdominal pain.
- Further investigation may be needed to understand the multifactorial causes of pediatric RAP.
- Current diagnostic approaches for lactose malabsorption may require refinement for pediatric populations.
Abstract:
In order to evaluate the role of lactose malabsorption in children with recurrent abdominal pain, we performed a prospective controlled double-blinded study in 40 children with RAP of at least three months' duration. Children were studied for lactose malabsorption by breath hydrogen determinations after ingestion of lactose (2 gm/kg of body weight; maximum 50 gm). Lactose malabsorbers were retested with 12.5 gm lactose; lactose absorbers were retested with lactose for ability to produce hydrogen. All children underwent a dietary trial which included two lactose elimination periods. Although 12 children (30%) were lactose malabsorbers, only three malabsorbed part of the smaller, more physiologic, lactose load. Improvement rates of lactose malabsorbers and absorbers during lactose elimination were not significantly different as judged by their physicians and as determined by a 50% or more decrease in pain frequency. These results suggest that lactose malabsorption is of little importance in children with RAP.