Abstract
The role of lactose intolerance was assessed prospectively in 47 consecutive children (4.2-15 yrs: mean 9.5)presenting as outpatients with RAP. Milk ingestion and pain frequency (documented by diary) and symptom production following lactose ingestion (2gm/kg; max. 50 gm) were correlated with lactose malabsorption determined by breath hydrogen excretion (> 10 parts per million above baseline)- an accurate technique for demonstrating disaccharide malabsorption in children(Perman,JA et al, Ped. Res. 11:488, 1977). Lactose malabsorbers underwent a 3-stage elimination diet including a regular diet control period. There were no differences between lactose malabsorbers and absorbers with regard to amount of milk ingested (1.6 vs 1.7 glasses/day; p>0.5)or pain frequency (11.7 vs 8.4 episodes/week; p>0.5). Lactose malabsorption occurred in 20 children(43%), 9/34 were Caucasian, 8/11 Black and 2/2 Hispanic. Cramps or diarrhea were reported in 82% of malabsorbers and 41% of absorbers. 11 of 20 malabsorbers have completed the diet trial; in 10 of 11 pts., pain frequency was reduced (paired t test; n=8; p<0.05): 3 patients refused to continue the control diet due to symptoms.
Conclusion: In RAP, lactose malabsorption is present and significantly contributes to symptoms in at least 1 in 4 pts, regardless of ethnic background-Milk ingestion, pain frequency and symptom response to lactose are unreliable indicators of lactose malabsorption. Thus, documentation of lactose malabsorption is indicated in children with recurrent abdominal pain.
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Barr, R., Watkins, J. & Levine, M. 395 RECURRENT ABDOMINAL PAIN (RAP) OF CHILDHOOD DUE TO LACTOSE INTOLERANCE: A PROSPECTIVE STUDY. Pediatr Res 12 (Suppl 4), 429 (1978). https://doi.org/10.1203/00006450-197804001-00400
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DOI: https://doi.org/10.1203/00006450-197804001-00400
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