Webster R B, DiPalma J A, Gremse D A
Division of Pediatric Gastroenterology and Nutrition, University of South Alabama, Mobile 36640-0130, USA.
Dig Dis Sci. 1995 Jul;40(7):1506-10. doi: 10.1007/BF02285199.
Our objectives were to evaluate children with recurrent abdominal pain for lactose maldigestion and to assess factors which might predict lactose absorption status. One hundred thirty-seven children were referred for specialty evaluation of recurrent abdominal pain of at least three months' duration. Study subjects were evaluated by history and physical examination, dietary interviews, hematologic and biochemical laboratory testing, stool parasite examination, and radiologic or endoscopic structural examinations, as indicated. Lactose hydrogen breath testing was performed after challenge with 1 g/kg lactose 10% aqueous solution). There were 53 males and 84 females, whose ages ranged from 6 to 18 years (9.64 +/- 2.9; mean +/- SD) Lactose maldigestion was detected in 33/137 patients (24%). The prevalence of abdominal pain, bloating, gas, flatulence, diarrhea, and constipation was similar in children with or without lactose maldigestion. The perception of symptoms related to the ingestion of dairy products was similar in both groups. No other clinical parameter predicted lactose maldigestion. However, children with lactose maldigestion had overall clinical improvement with a lactose-restricted diet. Clinical evaluation alone cannot adequately predict the presence of lactose maldigestion in children. Formal evaluation for lactose maldigestion using breath hydrogen testing methods should be considered in children with recurrent abdominal pain.
我们的目标是评估患有复发性腹痛的儿童是否存在乳糖消化不良，并评估可能预测乳糖吸收状态的因素。137名儿童因至少持续三个月的复发性腹痛而被转诊进行专科评估。根据需要，通过病史和体格检查、饮食访谈、血液学和生化实验室检测、粪便寄生虫检查以及放射学或内镜结构检查对研究对象进行评估。在用1g/kg乳糖10%水溶液激发后进行乳糖氢呼气试验。有53名男性和84名女性，年龄在6至18岁之间（9.64±2.9；平均值±标准差）。在137例患者中有33例（24%）检测到乳糖消化不良。有或无乳糖消化不良的儿童中，腹痛、腹胀、气体、肠胃胀气、腹泻和便秘的发生率相似。两组中与摄入乳制品相关的症状感知相似。没有其他临床参数可预测乳糖消化不良。然而，乳糖消化不良的儿童通过限制乳糖饮食总体临床症状有所改善。仅靠临床评估不能充分预测儿童乳糖消化不良的存在。对于复发性腹痛的儿童，应考虑使用呼气氢检测方法对乳糖消化不良进行正式评估。
