Fructose Intolerance Is Common in Children with Abdominal Pain

Fructose malabsorption or fructose intolerance is common in children with recurrent or functional abdominal pain.

Fructose intolerance is typically diagnosed by exclusion that once other gastro-intestinal conditions like Crohn's disease and ulcerative colitis are ruled out, a hydrogen breath test is given to the patient. If the patient's breath hydrogen exceeds 20 ppm points above baseline, then the patient is likely to be fructose intolerant.

Scientists at the Mary Bridge Children's Hospital, (Tacoma, WA, USA), investigated a total of 245 patients with unexplained chronic abdominal pain alone or associated with constipation, gas or bloating and/or diarrhea. The ages ranged from 2 to 18 years old, with a median age of 11 and 62.1% were female. The patients received a standard dose of fructose (1 g/kg, to a maximum of 25 g), followed by a breath hydrogen test (BHT), which measured methane levels at 30-minute intervals for 90 minutes. The test for fructose was performed in all patients in the study and it was positive for fructose intolerance in 132 of 245 patients (53.9 %). A total of 113 of 245 (46.1%) of patients had a negative BHT for fructose intolerance. All of the 132 patients with a positive BHT for fructose had a nutritional consult with a registered dietician and were placed on a low-fructose diet. Using a standard pain scale for children, 88 of the 132 patients (67.7%) reported resolution of symptoms on a low-fructose diet.

Daniel Lustig, M.D., a pediatric gastroenterologist at the hospital, said, "Fructose intolerance is more prevalent in teenage girls with chronic abdominal pain. While there is definitely a subset of patients who respond well to a low-fructose diet, it is challenging for patients who are fructose intolerant to maintain, especially teenagers. But the good news is that over half of patients who are fructose intolerant are able to maintain a low-fructose diet and are able to notice an immediate improvement in their symptoms.” The results of the study were unveiled at the American College of Gastroenterology's 75th Annual Scientific meeting, October 15 - 20, 2010, in San Antonio, TX, USA.

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Mary Bridge Children's Hospital