Department of Pediatrics, Rostock University Medical Center, Ernst-Heydemann-Str. 8, 18057, Rostock, Germany.
Centre for Immunobiology, Blizard Institute, Barts Cancer Institute, The Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
Sci Rep. 2020 Nov 4;10(1):18972. doi: 10.1038/s41598-020-75987-6.
Carbohydrate malabsorption and subsequent gastrointestinal symptoms are a common clinical problem in pediatrics. Hydrogen (H) and methane (CH) breath tests are a cheap and non-invasive procedure for diagnosing fructose and lactose malabsorption (FM/LM) but test accuracy and reliability as well as the impact of non-hydrogen producers (NHP) is unclear. CH breath tests (MBT), blood sugar tests (BST) and clinical symptoms were compared with H breath tests (HBT) for FM/LM. 187/82 tests were performed in children (2 to 18 years) with unclear chronic/recurrent abdominal pain and suspected FM/LM. In FM and LM, we found a significant correlation between HBT and MBT/BST. In LM, MBT differentiated most of the patients correctly and BST might be used as an exclusion test. However, additional MBT and BST had no diagnostic advantage in FM. NHP still remain a group of patients, which cannot be identified using the recommended CH cut-off values in FM or LM. Reported symptoms during breath tests are not a reliable method to diagnose FM/LM. Overall a combined test approach might help in diagnosing children with suspected carbohydrate malabsorption.
碳水化合物吸收不良和随后的胃肠道症状是儿科常见的临床问题。氢（H）和甲烷（CH）呼气试验是诊断果糖和乳糖吸收不良（FM/LM）的廉价、非侵入性方法，但测试准确性和可靠性以及非产氢菌（NHP）的影响尚不清楚。比较了 CH 呼气试验（MBT）、血糖试验（BST）和临床症状与 H 呼气试验（HBT）在 FM/LM 中的应用。对 187/82 例有不明原因慢性/复发性腹痛和疑似 FM/LM 的儿童进行了检查。在 FM 和 LM 中，我们发现 HBT 和 MBT/BST 之间存在显著相关性。在 LM 中，MBT 能正确区分大多数患者，BST 可作为排除性试验。然而，FM 中额外的 MBT 和 BST 并没有诊断优势。在 FM 或 LM 中，仍有一组 NHP 患者无法使用推荐的 CH 截断值来识别。呼吸试验期间报告的症状不是诊断 FM/LM 的可靠方法。总的来说，联合检测方法可能有助于诊断疑似碳水化合物吸收不良的儿童。
