Hydrogen breath test in schoolchildren.

Objective: to determine the prevalence of lactose malabsorption and its association with skin color and age in children and teenagers attending public schools in Porto Alegre, Brazil.Methods: a cross-sectional study was performed with 225 subjects between 8 and 18 years attending two public schools in Porto Alegre, Brazil. Patients were randomly selected. Subjects were classified according to skin color (white and nonwhite) and age group (8 to 12 and 13 to 18 years). Lactose malabsorption was diagnosed using the breath hydrogen test after ingestion of 250 ml of whole cow milk. The test lasted for 3 hours, with collections after fasting and 60, 120, and 180 minutes after milk ingestion. Malabsorption was determined in the presence of increase of >20 ppm in hydrogen concentration regarding the basal levels.Results: two-hundred and twenty-five students were studied, with a mean age ± standard deviation of 12.2 ± 2.0 years. The subjects consisted of 134 females (59.6%); 154 white (68.4%); and 71 nonwhite. Lactose malabsorption was observed in 19/225 cases (8.4%). It was diagnosed in 8/154 white patients (5.2%) and in 11/71 nonwhite patients (15.5%) (P= 0.02). Regarding the age group, we found 15/143 cases of malabsorption in students between 8 and 12 years (10.5%), and 4/82 cases in students between 13 and 18 years (4.9%) (P = 0.227).Conclusions: the prevalence of lactose malabsorption in students attending public schools in Porto Alegre is significant, especially if we consider that the physiological doses (250 ml of milk) were used for diagnosis. The malabsorption rate was higher among nonwhite children, which confirms the influence of race on primary adult type hypolactasia. No association was observed between lactose malabsorption and age group. (Rio J) 2002; 78 (3): 213-18: lactose malabsorption, cow milk, breath hydrogen test. J Pediatr ResumoObjetivo: determinar a prevalência de má absorção de lactose e sua associação com a cor da pele e com a idade em crianças e adolescentes de escolas públicas do município de Porto Alegre.Métodos: foi realizado um estudo transversal, que incluiu 225 indivíduos de 8 a 18 anos, alunos de duas escolas públicas do município de Porto Alegre. A seleção dos alunos ocorreu através de sorteio. Os participantes foram classificados segundo a cor da pele (brancos e não-brancos), e a faixa etária (8 a 12 e 13 a 18 anos). A má absorção de lactose foi diagnosticada através do teste do hidrogênio expirado após ingestão de 250ml de leite de vaca integral industrializado. O teste teve duração de 3 horas, com coletas em jejum e aos 60, 120 e 180 minutos após a ingestão do leite. Foi considerado como critério de positividade o aumento > 20 ppm na concentração de hidrogênio em relação ao nível basal.Resultados: foram estudados 225 alunos, com uma média e desvio-padrão de idade de 12,2 ± 2,0 anos. Cento e trinta e quatro indivíduos eram do sexo feminino (59,6%). Cento e cinqüenta e quatro alunos eram de cor branca (68,4%) e os restantes, de cor não-branca. A má absorção de lactose foi ev...

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“…No entanto, há autores que demonstram uma proporção de até 9,2% de crianças colonizadas por flora incapaz de produzir hidrogênio 27 .…”

Section: Discussionunclassified

Má absorção de lactose em crianças e adolescentes: diagnóstico através do teste do hidrogênio expirado com o leite de vaca como substrato

Pretto¹,

Silveira²,

Menegaz³

et al. 2002

J. Pediatr. (Rio J.)

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“…1, Table 1). They probably lacked the appropriate colonic flora to produce hydrogen, either idiopathically (20, 21) or because of previous use of antibiotics (22). In Lesotho primary LM starts to appear around the age of two years (7), which coincides with the age when breast feeding is traditionally stopped.…”

Section: Discussionmentioning

confidence: 99%

Lactose Malabsorption and Giardiasis in Basotho School Children

et al. 1987

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The prevalence of primary, adult-type, lactose malabsorption was assessed by means of the hydrogen breath test after intake of 360 ml of full cream milk (approximately 18 g lactose) in 96 randomly selected Basotho school children, aged 5-15 years. Of 86 children who did not have diarrhoea in the previous week 82 (85%) were lactose malabsorbers, while 4 (5%) could not be classified because of undetectable hydrogen excretion. Milk intolerance presenting as diarrhoea was significantly (p less than 0.01) more common in children who associated previous abdominal complaints with milk intake and/or did not like milk. A negative hydrogen breath test was significantly (p less than 0.05) more often observed in children who had diarrhoea in the previous week. Giardia was present in 18 (19%) of 93 children. The incidence of giardiasis did not correlate with the presence of lactose malabsorption in children without diarrhoea in the previous week. However, milk intolerance presenting as diarrhoea was significantly (p less than 0.05) more common in children with giardiasis. The findings support the use of physiological quantities of milk in Basotho school children.

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“…Breath hydrogen responses show a great deal of individual variation, likely generated by factors such as variation in intestinal microflora and intestinal transit times in individuals. Additionally, there can be false‐negative test results in hydrogen nonproducers, which has been shown to occur in around 10–13% of healthy and symptomatic children . It has also been reported that the children who showed symptoms of diarrhea after consuming fruit juice had the highest breath hydrogen levels .…”

Section: Breath Hydrogen Testing Principles and Parametersmentioning

confidence: 99%

Developmental changes and fructose absorption in children: effect on malabsorption testing and dietary management

et al. 2013

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Fructose malabsorption came to prominence in the pediatric arena as so-called "apple juice diarrhea," with excess consumption of fructose being linked to gastrointestinal symptoms such as diarrhea and abdominal pain. Over the past two decades the amount of fructose in children's diets has been increasing in the United States. A test for fructose malabsorption has yet to be fully validated, due mainly to the lack of an established etiology. In animal models, however, the fructose transporter GLUT5 is developmentally regulated, and this could be consistent with the greater susceptibility of children, especially toddlers, to fructose malabsorption. Additionally, the available evidence indicates the fructose breath hydrogen test has no apparent diagnostic utility in infants younger than 1 year; it may, therefore, be advisable to test for malabsorption by dietary exclusion in these patients. The present review aims to expound on the biological basis for fructose malabsorption in children and evaluate the current evidence for diagnostic procedures in order to identify clinical testing strategies that can be recommended and areas where further investigation is required.

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Hydrogen breath test in schoolchildren.

Abstract: The frequency of a false negative hydrogen breath test was higher than previously reported, but this does not affect the superiority of this method of testing over the conventional blood glucose determination.

Cited by 30 publications

References 16 publications

Má absorção de lactose em crianças e adolescentes: diagnóstico através do teste do hidrogênio expirado com o leite de vaca como substrato

Má absorção de lactose em crianças e adolescentes: diagnóstico através do teste do hidrogênio expirado com o leite de vaca como substrato

Lactose Malabsorption and Giardiasis in Basotho School Children

Developmental changes and fructose absorption in children: effect on malabsorption testing and dietary management

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