Chaussain M, Kheddari K, Roche R, Giusti B, Habib F, Badoual J, Dupont C, Gendrel D
Département de Pédiatrie, Hôpital Saint-Vincent-de-Paul, Paris.
Presse Med. 1994 May 21;23(19):881-5.
We performed the breath hydrogen test in children consulting for abdominal pain in order to determine the minimal quantity of lactose required to prove malabsorption with least patient incomfort and to evaluate the effect of an adapted diet in children with a positive test.
The breath hydrogen test after lactose intake was performed in 109 children (51 boys, 58 girls, mean age 8.2 + 3.2 years, range 3 to 15) seen for unexplained abdominal pain. All these children had complained of abdominal pain daily for at least 6 months and no other cause could be identified. Children with acute or chronic diarrhoea or constipation were excluded. Nineteen children had been transferred from the surgery unit and 6 had been followed by the psychiatry unit. All these children drank milk regularly.
The diagnosis of lactose intolerance was established in 83 children (76.1%) on the basis of a hydrogen peak in the breath after lactose ingestion. One-fourth of the children were of French origin and the others had at least one grandparent who was of Mediterranean or African origin. A lactose-free diet was proposed and led to the disappearance of abdominal pain in 24% and a clear improvement in 32%.
The breath hydrogen test is a simple non-invasive test which allows a selection of children who could benefit from a lactose-free diet although it cannot be used to predict the effect of diet.
我们对因腹痛前来咨询的儿童进行了呼气氢试验，以确定能够证实吸收不良所需的最低乳糖量，同时尽量减少患者的不适，并评估饮食调整对试验结果呈阳性的儿童的影响。
对109名因不明原因腹痛前来就诊的儿童（51名男孩，58名女孩，平均年龄8.2±3.2岁，年龄范围3至15岁）进行了乳糖摄入后的呼气氢试验。所有这些儿童均称每天腹痛至少6个月，且未发现其他病因。排除患有急性或慢性腹泻或便秘的儿童。其中19名儿童来自外科病房，6名儿童曾在精神科接受治疗。所有这些儿童均经常饮用牛奶。
根据乳糖摄入后呼出气体中的氢峰值，83名儿童（76.1%）被诊断为乳糖不耐受。四分之一的儿童为法国血统，其他儿童至少有一位祖父母是地中海或非洲血统。我们建议采用无乳糖饮食，结果显示腹痛消失的儿童占24%，明显改善的儿童占32%。
呼气氢试验是一种简单的非侵入性检查，可筛选出可能从无乳糖饮食中获益的儿童，尽管它不能用于预测饮食效果。
