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Disaccharidase Deficiencies in Children With Chronic Abdominal Pain.
JPEN J Parenter Enteral Nutr. 2017 03; 41(3):463-469.JJ

Abstract

OBJECTIVES

Carbohydrate intolerance or malabsorption has been suggested as a cause of chronic abdominal pain (CAP) in a subset of patients. We aimed to evaluate disaccharidase deficiencies in children with functional CAP and to correlate deficiencies with clinical features.

METHOD

Patients presenting to the gastroenterology clinic at Children's Hospital of Wisconsin with abdominal pain prospectively completed a detailed demographic, history, and symptom questionnaire. The CAP cohort included those with at least 1 month of symptoms. Data on disaccharidase activity and histology of endoscopic biopsies were collected retrospectively. Only patients with normal histology were included in the study. The association between groups with low disaccharidases and clinical features was examined.

RESULTS

A total of 203 pediatric patients with CAP were included. The mean (SD) age was 11.5 (3.1) years, and 32.5% were male. The percentages of abnormally low disaccharidase levels using the standard laboratory cutoffs were lactase, 37%; sucrase, 21%; glucoamylase, 25%; and palatinase, 8%. Thirty-nine percent of the patients with low lactase also had low sucrase, and 67% of the patients with low sucrase had low lactase. There was no significant difference in the activities of any of the disaccharidases or sucrase/lactase ratio in relation to age. Also, no association was found between stool consistency, stool frequency, or location of pain and low disaccharidase activity.

CONCLUSIONS

A large proportion of patients with CAP have deficiencies in disaccharidases. Bowel frequency, vomiting, or location of pain was no different between groups, suggesting that these clinical features cannot be used to predict disaccharidase deficiencies.

Authors+Show Affiliations

1 Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.1 Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.1 Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26160252

Citation

El-Chammas, Khalil, et al. "Disaccharidase Deficiencies in Children With Chronic Abdominal Pain." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 41, no. 3, 2017, pp. 463-469.
El-Chammas K, Williams SE, Miranda A. Disaccharidase Deficiencies in Children With Chronic Abdominal Pain. JPEN J Parenter Enteral Nutr. 2017;41(3):463-469.
El-Chammas, K., Williams, S. E., & Miranda, A. (2017). Disaccharidase Deficiencies in Children With Chronic Abdominal Pain. JPEN. Journal of Parenteral and Enteral Nutrition, 41(3), 463-469. https://doi.org/10.1177/0148607115594675
El-Chammas K, Williams SE, Miranda A. Disaccharidase Deficiencies in Children With Chronic Abdominal Pain. JPEN J Parenter Enteral Nutr. 2017;41(3):463-469. PubMed PMID: 26160252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disaccharidase Deficiencies in Children With Chronic Abdominal Pain. AU - El-Chammas,Khalil, AU - Williams,Sara E, AU - Miranda,Adrian, Y1 - 2016/07/11/ PY - 2015/7/15/pubmed PY - 2017/12/29/medline PY - 2015/7/11/entrez KW - carbohydrate malabsorption KW - chronic abdominal pain KW - disaccharidases KW - functional gastrointestinal disorders SP - 463 EP - 469 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 41 IS - 3 N2 - OBJECTIVES: Carbohydrate intolerance or malabsorption has been suggested as a cause of chronic abdominal pain (CAP) in a subset of patients. We aimed to evaluate disaccharidase deficiencies in children with functional CAP and to correlate deficiencies with clinical features. METHOD: Patients presenting to the gastroenterology clinic at Children's Hospital of Wisconsin with abdominal pain prospectively completed a detailed demographic, history, and symptom questionnaire. The CAP cohort included those with at least 1 month of symptoms. Data on disaccharidase activity and histology of endoscopic biopsies were collected retrospectively. Only patients with normal histology were included in the study. The association between groups with low disaccharidases and clinical features was examined. RESULTS: A total of 203 pediatric patients with CAP were included. The mean (SD) age was 11.5 (3.1) years, and 32.5% were male. The percentages of abnormally low disaccharidase levels using the standard laboratory cutoffs were lactase, 37%; sucrase, 21%; glucoamylase, 25%; and palatinase, 8%. Thirty-nine percent of the patients with low lactase also had low sucrase, and 67% of the patients with low sucrase had low lactase. There was no significant difference in the activities of any of the disaccharidases or sucrase/lactase ratio in relation to age. Also, no association was found between stool consistency, stool frequency, or location of pain and low disaccharidase activity. CONCLUSIONS: A large proportion of patients with CAP have deficiencies in disaccharidases. Bowel frequency, vomiting, or location of pain was no different between groups, suggesting that these clinical features cannot be used to predict disaccharidase deficiencies. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/26160252/Disaccharidase_Deficiencies_in_Children_With_Chronic_Abdominal_Pain_ L2 - https://doi.org/10.1177/0148607115594675 DB - PRIME DP - Unbound Medicine ER -