Gomara Robert E, Halata Michael S, Newman Leonard J, Bostwick Howard E, Berezin Stuart H, Cukaj Lynnette, See Mary C, Medow Marvin S
Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, New York Medical College, Valhalla, NY 10595, USA.
J Pediatr Gastroenterol Nutr. 2008 Sep;47(3):303-8. doi: 10.1097/MPG.0b013e318166cbe4.
We determined the occurrence of fructose malabsorption in pediatric patients with previous diagnoses of abdominal pain caused by a functional bowel disorder, whether the restriction of fructose intake changes the reporting of symptoms, the role of fructose dosage, and the severity of resultant symptoms.
We administered a fructose breath test to children presenting with persistent unexplained abdominal pain. Patients randomly received 1, 15, or 45 g fructose, and breath hydrogen was measured for 3 hours after ingestion. Test results were positive when breath hydrogen was 20 ppm greater than baseline and was accompanied by gastrointestinal symptoms.
A total of 32 patients was enrolled, and none of the 9 who received 1 g had positive results. Three of 10 who received 15 g and 8 of 13 who received 45 g had positive results. All patients with positive test results restricted their fructose intake. Among the group with positive results, 9 of 11 had rapid improvement of their gastrointestinal symptoms. After 2 months, all 9 patients continued to report improvement.
We concluded that fructose malabsorption may be a significant problem in children and that management of dietary intake can be effective in reducing gastrointestinal symptoms.
我们确定了先前诊断为功能性肠病引起腹痛的儿科患者中果糖吸收不良的发生率，果糖摄入量的限制是否会改变症状报告、果糖剂量的作用以及由此产生症状的严重程度。
我们对患有持续性不明原因腹痛的儿童进行了果糖呼气试验。患者随机接受1克、15克或45克果糖，并在摄入后3小时测量呼气氢气。当呼气氢气比基线高20 ppm并伴有胃肠道症状时，测试结果为阳性。
共纳入32例患者，接受1克果糖的9例患者均无阳性结果。接受15克果糖的10例中有3例阳性，接受45克果糖的13例中有8例阳性。所有测试结果为阳性的患者都限制了果糖摄入量。在阳性结果组中，11例中有9例胃肠道症状迅速改善。2个月后，所有9例患者仍报告症状改善。
我们得出结论，果糖吸收不良可能是儿童中的一个重要问题，饮食摄入管理可有效减轻胃肠道症状。
