Abstract
Fructose malabsorption is regarded as one of the most common types of sugar intolerance. However, the correlation between gastrointestinal symptoms and positive results in fructose hydrogen breath tests (HBTs) remains unclear. The aim of this study was to assess the clinical importance of positive fructose HBT by correlating the HBT results with clinical features in children with various gastrointestinal symptoms. Clinical features and fructose HBT results were obtained from 323 consecutive children (2–18 years old, mean 10.7 ± 4.3 years) that were referred to the Tertiary Paediatric Gastroenterology Centre and diagnosed as having functional gastrointestinal disorders. A total of 114 out of 323 children (35.3%) had positive HBT results, of which 61 patients were females (53.5%) and 53 were males (46.5%). Children with positive HBT were significantly younger than children with negative HBT (9.0 vs. 11.6 years old; p < 0.001). The most frequent symptom among children with fructose malabsorption was recurrent abdominal pain (89.5%). Other important symptoms were diarrhoea, nausea, vomiting, and flatulence. However, no correlation between positive fructose HBT results and any of the reported symptoms or general clinical features was found. In conclusion, positive fructose HBT in children with functional gastrointestinal disorders can be attributed to their younger age but not to some peculiar clinical feature of the disease.
Highlights
Introduction iationsFructose malabsorption (FM) is the result of the insufficient absorption and subsequent bacterial fermentation of this sugar in the lumen of the gastrointestinal tract
There were no significant differences between the number of positive test results found for each sex
Patients with positive and negative hydrogen breath test (HBT) results were similar regarding the value of the standard deviation score (SDS) for weight, height, and body mass index (BMI)
Summary
Fructose malabsorption (FM) is the result of the insufficient absorption and subsequent bacterial fermentation of this sugar in the lumen of the gastrointestinal tract. FM may be the direct cause of symptoms in a condition called intestinal fructose intolerance (FI) [1]. Due to the increased intake of fructose in modern diets, more attention has been paid to the possible role of FI in the symptomatology of gastrointestinal disorders. The ability to absorb fructose in the small intestine is limited and specific for each person [2,3]. Increased intakes of fructose may exceed people’s absorption capabilities. As a result, unabsorbed fructose may remain in the lumen of the small intestine and causes some specific symptoms
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