Dietary lactose and the child with abdominal pain.

Dearlove, J; Dearlove, B. A.; Pearl, K N; Primavesi, Robert

doi:10.1136/bmj.286.6382.1936

Cited by 45 publications

(26 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four trials investigated fiber supplements compared with placebo, 24,[36][37][38] and 2 trials studied a lactose-free diet. 39,40 Four trials investigated probiotics, 27,41-43 and 3 trials compared HT versus standard care or a wait-list. 25,32,44 Seven studies compared CBT with standard care, physiotherapy, fiber supplements, biofeedback, and/or parental support.…”

Section: Resultsmentioning

confidence: 99%

“…Six trials did not present results with absolute numbers and were therefore not included in the meta-analysis. 27,39,40,44,47,48 Analyses for follow-up were uncontrolled for baseline differences by Levy et al 31 Because participants were recruited through physician referral and flyers, these patients were therefore seriously motivated, which can cause bias.…”

Section: Methodologic Qualitymentioning

confidence: 99%

“…39,40 Lebenthal et al 40 enrolled 95 participants. After an intestinal biopsy was conducted, those patients with abnormal lactase activity (12-20 U) were excluded: 69 children received 6 weeks of lactosecontaining or lactose-free infant formula.…”

Section: Lactose-free Dietmentioning

confidence: 99%

“…55 However, neither lactose nor fructose intolerance was established as a cause of pain in 220 children with RAP in a recent study, 58 and lactose restriction did not improve symptoms in pediatric trials. 39,40 Recently, diets of low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) have been extensively studied in adults.…”

Section: Alternative Medicinementioning

confidence: 99%

See 3 more Smart Citations

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine.METHODS: Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach.RESULTS: Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P , .05). Guar gum significantly improved irritable bowel syndrome symptom frequency; however, no effect was found for other fiber supplements (relative risk: 1.17 [95% confidence interval: 0.75 to 1.81]) or a lactose-free diet. Functional disability was not significantly decreased after yoga compared with a wait-list approach. No studies were found concerning lifestyle interventions; gluten-, histamine-, or carbonic acid-free diets; fluid intake; or prebiotics. No serious adverse effects were reported. The quality of evidence was found to be very low to moderate. CONCLUSIONS:Although high-quality studies are lacking, some evidence shows efficacy of hypnotherapy, cognitive behavioral therapy, and probiotics (LGG and VSL#3) in pediatric AP-FGIDs. Data on fiber supplements are inconclusive.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodologic Qualitymentioning

confidence: 99%

Section: Lactose-free Dietmentioning

confidence: 99%

Section: Alternative Medicinementioning

confidence: 99%

See 2 more Smart Citations

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

View full text Add to dashboard Cite

show abstract

“…50 This followed a 2-week baseline period of the child's regular diet and a 2-week period of a lactose-free diet, which was maintained during the intervention. The lactose and placebo were allocated at random using a doubleblind, single crossover design.…”

Section: Lactose Avoidance: Dearlove Et Almentioning

confidence: 99%

Systematic Review of Treatments for Recurrent Abdominal Pain

Weydert

Ball²,

Davis³

2003

Pediatrics

193

100

View full text Add to dashboard Cite

ABSTRACT.Objective. To conduct a systematic review of evaluated treatments for recurrent abdominal pain (RAP) in children.Methods. Online bibliographic databases were searched for the terms "recurrent abdominal pain," "functional abdominal pain," "children," or "alternative therapies" in articles classified as randomized controlled trials. The abstracts or full text of 57 relevant articles were examined; 10 of these met inclusion criteria. Inclusion criteria required that the study involve children aged 5 to 18 years, subjects have a diagnosis of RAP, and that subjects were allocated randomly to treatment or control groups. The methodology and findings of these articles were evaluated critically, and data were extracted from each article regarding study methods, specific interventions, outcomes measured, and results.Results. Studies that evaluated famotidine, pizotifen, cognitive-behavioral therapy, biofeedback, and peppermint oil enteric-coated capsules showed a decrease in measured pain outcomes for those who received the interventions when compared with others in control groups. The studies that evaluated dietary interventions had conflicting results, in the case of fiber, or showed no efficacy, in the case of lactose avoidance.Conclusions. Evidence for efficacy of treatment of RAP in children was found for therapies that used famotidine, pizotifen, cognitive-behavioral therapy, biofeedback, and peppermint oil enteric-coated capsules. The effects of dietary fiber were less conclusive, and the use of a lactose-free diet showed no improvement. There seemed to be greater improvement when therapy (famotidine, pizotifen, peppermint oil) was targeted to the specific functional gastrointestinal disorder (dyspepsia, abdominal migraine, irritable bowel syndrome). The behavioral interventions seemed to have a general positive effect on children with nonspecific RAP. Many of these therapies have not been used widely as standard treatment for children with RAP. Although the mechanism of action for each effective therapy is not fully understood, each is believed to be safe for use in RAP. Pediatrics 2003;111:e1-e11. URL: http://www.pediatrics.org/cgi/ content/full/111/1/e1; recurrent abdominal pain, treatment, children, alternative therapies, systematic review.ABBREVIATIONS. RAP, recurrent abdominal pain; IBS, irritable bowel syndrome; RCT, randomized controlled trial; SPC, standard pediatric care; CBFI, cognitive-behavioral family intervention; BF, biofeedback; CBI, cognitive-behavioral intervention.

show abstract