title: Fructose intolerance/malabsorption and recurrent abdominal pain in children.
abstract: OBJECTIVE
  The purpose of the present study was to ascertain whether pediatric patients with chronic abdominal pain had concurrent fructose intolerance as determined by a standardized dose breath hydrogen test (BHT), and whether symptoms would improve with a low-fructose diet.
  
  
  METHODS
  The fructose BHT test was administered to patients evaluated in clinic with unexplained chronic abdominal pain alone or associated with constipation, gas or bloating, and/or diarrhea. The patients were given a standard dose of 1 g/kg fructose to maximum of 25 g. Hydrogen and methane were measured at 8 time points. The test was presumed positive if breath hydrogen exceeded 20 ppm above baseline. If positive, patients were given a dietitian-prescribed low-fructose diet.
  
  
  RESULTS
  A total of 222 patients were part of the study. Ages ranged from 2 to 19 years with a mean of 10.5. BHT for fructose was performed in all of the patients and it was positive for fructose intolerance in 121 of 222 patients (54.5%). A total of 101 of 222 (45.5%) patients had negative BHT for fructose intolerance. All BHT-positive patients had a nutrition consult with a registered dietitian and were placed on a low-fructose diet. Using a standard pain scale for children, 93 of 121 patients (76.9%) reported resolution of symptoms on a low-fructose diet (P < 0.0001). Furthermore, 55 of 101 patients (54.4%) with negative BHT for fructose reported resolution of symptoms without a low-fructose diet (P = 0.37).
  
  
  CONCLUSIONS
  Fructose intolerance/malabsorption is common in children with recurrent/functional abdominal pain and a low-fructose diet is an effective treatment.
authors.affiliation: *Mary Bridge Children's Hospital and Health Center †MultiCare Institute for Research & Innovation, Tacoma, WA.
authors.forename: Mauricio A
authors.initials: MA
authors.lastname: Escobar
authors.forename: Daniel
authors.initials: D
authors.lastname: Lustig
authors.forename: Bethann M
authors.initials: BM
authors.lastname: Pflugeisen
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Amoroso
authors.forename: Dalia
authors.initials: D
authors.lastname: Sherif
authors.forename: Rasha
authors.initials: R
authors.lastname: Saeed
authors.forename: Shaza
authors.initials: S
authors.lastname: Shamdeen
authors.forename: Judith
authors.initials: J
authors.lastname: Tuider
authors.forename: Bisher
authors.initials: B
authors.lastname: Abdullah
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005260:Female; D005632:Fructose / Q000008:administration & dosage*; D005633:Fructose Intolerance / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy*; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D008286:Malabsorption Syndromes / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy*; D008297:Male; D008697:Methane / Q000032:analysis; D010147:Pain Measurement; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D005632:Fructose; D006859:Hydrogen; D008697:Methane