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Stool Reducing Sugars and Stool pH Are Poor Screening Tests for Intestinal Disaccharidase Deficiencies in Children.
J Appl Lab Med. 2020 Mar 01; 5(2):257-262.JA

Abstract

BACKGROUND

Tests for stool reducing sugars and stool pH are ordered for children with osmotic diarrhea to screen for carbohydrate malabsorption.

METHODS

We compared the results of the two screening tests, stool reducing sugars and stool pH, with a more definitive result from an intestinal tissue disaccharidase activity assay ordered for pediatric patients (<18 years old). Overall, 159 patients had results for tissue disaccharidase and stool reducing sugars, but only 115 had additional results of stool pH. Forty-six of the 159 patients had mild, moderate, or severe disaccharidase deficiencies. The sensitivity and specificity of the screening tests were calculated for individual disaccharidase deficiencies. In addition, trends of abnormal tissue disaccharidase, stool reducing sugars, and stool pH results were examined in different age groups.

RESULTS

The sensitivities for stool reducing sugars and stool pH were 9% to 28% and specificities were 74% to 81% for individual disaccharidase deficiencies. Infants (0 years of age) had the highest percentage of abnormal results across all three tests; however, the positive predicative values were 54% and 50% for stool reducing sugars and stool pH, respectively.

CONCLUSIONS

The screening tests, stool reducing sugars and stool pH, had low sensitivity compared with results of measured tissue disaccharidase activity in pediatric patients. Infants had the highest percentage of abnormal results for all three tests, but the screening tests still performed poorly in that age group. This study suggests that stool reducing sugars and stool pH should not be used as screening tests for carbohydrate malabsorption due to disaccharidase deficiencies in pediatric patients.

Authors+Show Affiliations

ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT.ARUP Laboratories, Salt Lake City, UT.ARUP Laboratories, Salt Lake City, UT.ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT. ARUP Laboratories, Salt Lake City, UT. Department of Pathology, University of Utah, Salt Lake City, UT.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32445391

Citation

Erickson, J Alan, et al. "Stool Reducing Sugars and Stool pH Are Poor Screening Tests for Intestinal Disaccharidase Deficiencies in Children." The Journal of Applied Laboratory Medicine, vol. 5, no. 2, 2020, pp. 257-262.
Erickson JA, Case K, Neider C, et al. Stool Reducing Sugars and Stool pH Are Poor Screening Tests for Intestinal Disaccharidase Deficiencies in Children. J Appl Lab Med. 2020;5(2):257-262.
Erickson, J. A., Case, K., Neider, C., & Johnson, L. M. (2020). Stool Reducing Sugars and Stool pH Are Poor Screening Tests for Intestinal Disaccharidase Deficiencies in Children. The Journal of Applied Laboratory Medicine, 5(2), 257-262. https://doi.org/10.1093/jalm/jfz017
Erickson JA, et al. Stool Reducing Sugars and Stool pH Are Poor Screening Tests for Intestinal Disaccharidase Deficiencies in Children. J Appl Lab Med. 2020 Mar 1;5(2):257-262. PubMed PMID: 32445391.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stool Reducing Sugars and Stool pH Are Poor Screening Tests for Intestinal Disaccharidase Deficiencies in Children. AU - Erickson,J Alan, AU - Case,Kristin, AU - Neider,Cole, AU - Johnson,Lisa M, PY - 2019/07/15/received PY - 2019/08/19/accepted PY - 2020/5/24/entrez PY - 2020/5/24/pubmed PY - 2020/5/24/medline KW - children KW - diarrhea KW - disaccharidase KW - feces KW - gastrointestinal KW - malabsorption KW - stool KW - stool pH KW - stool reducing sugars SP - 257 EP - 262 JF - The journal of applied laboratory medicine JO - J Appl Lab Med VL - 5 IS - 2 N2 - BACKGROUND: Tests for stool reducing sugars and stool pH are ordered for children with osmotic diarrhea to screen for carbohydrate malabsorption. METHODS: We compared the results of the two screening tests, stool reducing sugars and stool pH, with a more definitive result from an intestinal tissue disaccharidase activity assay ordered for pediatric patients (<18 years old). Overall, 159 patients had results for tissue disaccharidase and stool reducing sugars, but only 115 had additional results of stool pH. Forty-six of the 159 patients had mild, moderate, or severe disaccharidase deficiencies. The sensitivity and specificity of the screening tests were calculated for individual disaccharidase deficiencies. In addition, trends of abnormal tissue disaccharidase, stool reducing sugars, and stool pH results were examined in different age groups. RESULTS: The sensitivities for stool reducing sugars and stool pH were 9% to 28% and specificities were 74% to 81% for individual disaccharidase deficiencies. Infants (0 years of age) had the highest percentage of abnormal results across all three tests; however, the positive predicative values were 54% and 50% for stool reducing sugars and stool pH, respectively. CONCLUSIONS: The screening tests, stool reducing sugars and stool pH, had low sensitivity compared with results of measured tissue disaccharidase activity in pediatric patients. Infants had the highest percentage of abnormal results for all three tests, but the screening tests still performed poorly in that age group. This study suggests that stool reducing sugars and stool pH should not be used as screening tests for carbohydrate malabsorption due to disaccharidase deficiencies in pediatric patients. SN - 2576-9456 UR - https://www.unboundmedicine.com/medline/citation/32445391/Stool_Reducing_Sugars_and_Stool_pH_Are_Poor_Screening_Tests_for_Intestinal_Disaccharidase_Deficiencies_in_Children L2 - http://jalm.aaccjnls.org/cgi/pmidlookup?view=long&amp;pmid=32445391 DB - PRIME DP - Unbound Medicine ER -
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