title: Significance of hydrogen breath tests in children with suspected carbohydrate malabsorption.
abstract: BACKGROUND
  Hydrogen breath tests are noninvasive procedures frequently applied in the diagnostic workup of functional gastrointestinal disorders. Here, we review hydrogen breath test results and the occurrence of lactose, fructose and sorbitol malabsorption in pediatric patients; and determine the significance of the findings and the outcome of patients with carbohydrate malabsorption.
  
  
  METHODS
  We included 206 children (88 male, 118 female, median age 10.7 years, range 3-18 years) with a total of 449 hydrogen breath tests (lactose, n = 161; fructose, n = 142; sorbitol, n = 146) into a retrospective analysis. Apart from test results, we documented symptoms, the therapeutic consequences of the test, the outcome and the overall satisfaction of the patients and families.
  
  
  RESULTS
  In total, 204 (46%) of all breath tests were positive. Long-term follow-up data could be collected from 118 patients. Of 79 patients (67%) who were put on a diet reduced in lactose, fructose and/or sorbitol, the majority (92%, n = 73) reported the diet to be strict and only 13% (n = 10) had no response to diet. Most families (96%, n = 113) were satisfied by the test and the therapy. There were only 21 tests (5%) with a borderline result because the criteria for a positive result were only partially met.
  
  
  CONCLUSIONS
  Hydrogen breath tests can be helpful in the evaluation of children with gastrointestinal symptoms including functional intestinal disorders. If applied for a variety of carbohydrates but only where indicated, around two-third of all children have positive results. The therapeutic consequences are successfully relieving symptoms in the vast majority of patients.
authors.forename: Jan
authors.initials: J
authors.lastname: Däbritz
authors.forename: Michael
authors.initials: M
authors.lastname: Mühlbauer
authors.forename: Dirk
authors.initials: D
authors.lastname: Domagk
authors.forename: Nicole
authors.initials: N
authors.lastname: Voos
authors.forename: Geraldine
authors.initials: G
authors.lastname: Henneböhl
authors.forename: Maria L
authors.initials: ML
authors.lastname: Siemer
authors.affiliation: Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Röntgenstr 21, Münster 48149, NRW, Germany. dfoell@uni-muenster.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Foell
mesh_terms: D000293:Adolescent; D001944:Breath Tests; D002239:Carbohydrate Metabolism, Inborn Errors / Q000175:diagnosis* / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005632:Fructose / Q000378:metabolism*; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000378:metabolism*; D006801:Humans; D006859:Hydrogen / Q000032:analysis* / Q000378:metabolism*; D007785:Lactose / Q000378:metabolism*; D008286:Malabsorption Syndromes / Q000175:diagnosis* / Q000378:metabolism*; D008297:Male; D012189:Retrospective Studies; D013012:Sorbitol / Q000378:metabolism*
chemical_list: D005632:Fructose; D013012:Sorbitol; D006859:Hydrogen; D007785:Lactose