Fructose Malabsorption in Children with Recurrent Abdominal Pain: Positive Effects of Dietary Treatment

 

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Abstract

Objective: The objective of this study was to analyze the effect of a fructose-restricted diet in otherwise healthy children with abdominal pain and pathologic fructose hydrogen breath test.

Subjects and methods: 75 children (aging 3–14 years) with recurrent abdominal pain without gastrointestinal disease and fructose malabsorption followed a fructose restricted diet for 4 weeks.

Results: A median decline of weekly pain frequency from 4 (mean 3.64+1.6) before diet to 1 (mean 1.46+1.4; p<0.001) under fructose restriction was documented. The intensity of pain decreased from median 6 (mean 5.83+2.0) before intervention to median 3 (mean 3.4+2.5; p<0.001) with diet. Several additional life quality-influencing parameters such as daily stool frequency, nausea, problems to fall asleep, missed school days also improved significantly.

Conclusions: Our study provides evidence that dietary fructose restriction represents a useful approach to address recurrent abdominal symptoms in children with fructose malabsorption.

Zusammenfassung

Ziel: Das Ziel der Untersuchung war die Analyse des Effekts einer fruktosereduzierten Ernährung bei anderweitig gesunden Kindern mit rezidivierenden Bauchschmerzen und einem pathologischen Fruktose-H₂-Atemtest.

Patienten und Methode: 75 Kinder im Alter von 3–14 Jahren mit rezidivierenden Bauchschmerzen ohne gastrointestinale Erkrankung und Fruktosemalabsorption unterzogen sich einer fruktosereduzierten Diät über 4 Wochen.

Ergebnisse: Die wöchentliche Bauchschmerzfrequenz reduzierte sich im Median von 4 (Mittelwert 3,64+1,6) vor Diät auf 1 (Mittelwert 1,46+1,4; p<0,001) unter fruktosereduzierter Kost. Die Schmerzintensität nahm im Median von 6 (Mittelwert 5,83+2,0) vor der Intervention auf 3 (Mittelwert 3,4+2,5; p<0,001) unter Diät ab. Weitere die Lebensqualität beeinflussende Parameter wie die tägliche Stuhlfrequenz, Übelkeit, Einschlafstörungen und Schulfehltage erfuhren eine signifikante Verbesserung.

Schlussfolgerung: Unsere Ergebnisse zeigen, dass eine fruktosereduzierte Ernährung eine effektive Intervention bei Kindern und Jugendlichen mit Fruktosemalabsorption und rezidivierenden Bauchschmerzen sein kann.

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Correspondence

Prof. Dr. Stefan Wirth

Zentrum für Kinder- und

Jugendmedizin

Universität Witten/Herdecke

HELIOS Klinikum Wuppertal

Heusnerstraße 40

42283 Wuppertal

Germany

Phone: +49/202/896 38 33

Fax: +49/202/896 38 34

Email: stefan.wirth@helios-kliniken.de