title: Positive or negative fructose breath test results do not predict response to fructose restricted diet in children with recurrent abdominal pain: results from a prospective randomized trial.
abstract: OBJECTIVE
  To perform a prospective, blinded, randomized interventional trial in patients with recurrent abdominal pain. The primary endpoint was to determine the abdominal pain intensity after 2 weeks of fructose restricted diet. Secondary endpoints were changes of pain frequency and a secondary symptom score (SSS).
  
  
  METHODS
  103 individuals with recurrent abdominal pain for more than 3 months were randomized. 51 patients were allocated to group A (diet) and 52 to group B (no diet). 2 weeks later the patients underwent hydrogen breath test and were assigned to the test positive or negative group to identify patients with fructose malabsorption.
  
  
  RESULTS
  2 weeks after intervention the pain score decreased significantly from a median 5.5 in group A to 4 and did not change significantly in group B (5.3 to 5). In group A both patients with positive and negative breath tests had a significant lower pain score (-2 and -1.75, respectively). Frequency of abdominal pain decreased in both groups but without significant difference, SSS improved only in group A from median 6 to 3.5. Positive breath test was no predicting factor, neither was abdominal pain during the test.
  
  
  CONCLUSIONS
  Fructose restricted diet in children and adolescents with recurrent abdominal pain may be of benefit to improve both abdominal pain symptoms and other secondary symptoms. Since a negative breath test result does not exclude a positive response to fructose restriction, the hydrogen breath test does not seem to be the appropriate diagnostic mean to predict the response to the diet.
authors.affiliation: Department of Pediatrics, Helios Medical Centre, Witten-Herdecke University, Wuppertal, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wirth
authors.affiliation: Department of Pediatrics, Helios Medical Centre, Witten-Herdecke University, Wuppertal, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Klodt
authors.affiliation: Department of Pediatrics, Helios Medical Centre, Witten-Herdecke University, Wuppertal, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Wintermeyer
authors.affiliation: Department of Pediatrics, Klinikum Dortmund, Dortmund, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Berrang
authors.affiliation: Department of Pediatrics, Helios Medical Centre, Witten-Herdecke University, Wuppertal, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Hensel
authors.affiliation: Department of Pediatrics, Helios Medical Centre, Witten-Herdecke University, Wuppertal, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Langer
authors.affiliation: Department of Pediatrics, Helios Medical Centre, Witten-Herdecke University, Wuppertal, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Heusch
mesh_terms: D015746:Abdominal Pain / Q000178:diet therapy* / Q000209:etiology*; D000293:Adolescent; D001944:Breath Tests / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D050528:Diet, Carbohydrate-Restricted; D005260:Female; D005632:Fructose / Q000008:administration & dosage* / Q000009:adverse effects*; D005633:Fructose Intolerance / Q000175:diagnosis* / Q000178:diet therapy*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D005632:Fructose