Abstract
Abdominal pain has been associated with disaccharidase deficiencies. While relationships with individual symptoms have been assessed, relationships between disaccharidase deficiencies and symptom complexes or inflammation have not been evaluated in this group. The primary aims of the current study were to assess relationships between disaccharidase deficiency and symptoms or symptom complexes and duodenal inflammation, respectively. Patients with abdominal pain who underwent endoscopy with evaluation of disaccharidase activity levels were identified. After excluding all patients with inflammatory bowel disease, celiac disease, H. pylori, or gross endoscopic lesions, patients were evaluated for disaccharidase deficiency frequency. Disaccharidase were compared between patients with and without histologic duodenitis. Lastly, relationships between individual gastrointestinal symptoms or symptom complexes were evaluated. Lactase deficiency was found in 34.3% of patients and disaccharidase pan-deficiency in 7.6%. No individual symptoms or symptom complexes predicted disaccharidase deficiency. While duodenitis was not associated with disaccharidase deficiency, it was only present in 5.9% of patients. Disaccharidase deficiency, particularly lactase deficiency, is common in youth with abdominal pain and multiple deficiencies are not uncommon. Disaccharidase deficiency cannot be predicted by symptoms in this population. Further studies are needed to assess the clinical significance of disaccharidase deficiency.
Highlights
Abdominal pain has been associated with disaccharidase deficiencies
The primary aims of the current study were to, (1) assess the frequency of DS deficiency in children and adolescents with chronic abdominal pain, (2) to assess relationships between DS deficiencies and specific symptoms or groups of symptoms corresponding to symptoms generally associated with DS deficiency, irritable bowel syndrome (IBS), and functional dyspepsia (FD), respectively, and, (3) to assess relationships between duodenal inflammation and DS activity and deficiencies
We hypothesized that DS deficiency would be common in youth with chronic abdominal pain but would not be associated with specific symptoms or symptom complexes
Summary
Abdominal pain has been associated with disaccharidase deficiencies. While relationships with individual symptoms have been assessed, relationships between disaccharidase deficiencies and symptom complexes or inflammation have not been evaluated in this group. Disaccharidase (DS) deficiencies have been implicated in children with chronic abdominal pain[7,8,9] These may be primary deficiencies in patients with normal duodenal histology and presumably genetic in origin or may be secondary to mucosal injury with villous atrophy and/or inflammation. The primary aims of the current study were to, (1) assess the frequency of DS deficiency in children and adolescents with chronic abdominal pain, (2) to assess relationships between DS deficiencies and specific symptoms or groups of symptoms corresponding to symptoms generally associated with DS deficiency, IBS, and FD, respectively, and, (3) to assess relationships between duodenal inflammation and DS activity and deficiencies. We hypothesized that DS deficiency would be common in youth with chronic abdominal pain but would not be associated with specific symptoms or symptom complexes
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