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ISSN: 1734-1922
Archives of Medical Science
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vol. 14
Clinical research

Hydrogen excretion in pediatric lactose malabsorbers: relation to symptoms and the dose of lactose

Katarzyna Pawłowska, Rafał Seredyński, Wioleta Umławska, Barbara Iwańczak

Arch Med Sci 2018; 14, 1: 88–93
Online publish date: 2016/07/20
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Introduction: Lactose malabsorption arises from lactase deficiency and may lead to lactose intolerance – gastrointestinal symptoms after lactose ingestion. Occurrence and severity of the symptoms are influenced by many factors, including the dose of lactose and the intensity of its colonic fermentation to short chain fatty acids and gases.

Material and methods: The hydrogen breath test (HBT) after 30 g or 50 g of lactose was performed in 387 children. Further analysis included children who had a positive HBT result. The HBT parameters were net hydrogen concentration in each breath and total net hydrogen concentration during the HBT. The time of the first hydrogen rise was also calculated. HBT parameters were analyzed according to symptoms occurrence (lack or present), symptoms severity (lack, moderate or severe) and the dose of lactose (30 g or 50 g).

Results: One hundred and six children (12.1 years, 46 boys) had a positive HBT result. Symptoms occurrence was positively related to net hydrogen concentration at 30 min, 60 min and 90 min (p < 0.001 at each time point), as well as to the total net hydrogen concentration (p < 0.001). There were no differences in hydrogen excretion between subjects with moderate and severe symptoms after lactose ingestion. Symptoms were more frequent in subjects given 50 g of lactose than in those given 30 g of lactose (79% vs. 47%, p = 0.003). In both dose groups symptoms occurrence was related to hydrogen excretion.

Conclusions: Symptoms occurrence is closely related to hydrogen excretion and to the dose of ingested lactose.

children; gastrointestinal diseases, hydrogen breath test, lactose intolerance, lactose malabsorption

Monajemzadeh M, Ashtiani MTH, Sadrian E. Variation in plasma leptin levels in young Iranian children with cystic fibrosis. Arch Med Sci 2013; 9: 883-7.
Poursafa P, Kelishadi R, Amin MM, Hashemi M, Amin M. First report on the association of drinking water hardness and endothelial function in children and adolescents. Arch Med Sci 2014; 10: 746-51.
Pereira PC. Milk nutritional composition and its role in human health. Nutrition 2014; 30: 619-27.
He T, Venema K, Priebe MG, Welling GW, Brummer RJM, Vonk RJ. The role of colonic metabolism in lactose intolerance. Eur J Clin Invest 2008; 38: 541-7.
Perets TT, Shporn E, Aizic S, et al. A diagnostic approach to patients with suspected lactose malabsorption. Dig Dis Sci 2013; 59: 1012-6.
Vonk RJ, Priebe MG, Koetse HA, et al. Lactose intolerance: analysis of underlying factors. Eur J Clin Invest 2003; 33: 70-5.
Bianchi M, Tarquini M, Koch M, Capurso L. Correlation between symptoms and gas production in lactose intolerant subjects. Can symptoms predict a diagnosis of lactose intolerance? J Nutr Environ Med 2003; 13: 5-11.
Zhu Y, Zheng X, Cong Y, et al. Bloating and distention in irritable bowel syndrome: the role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency. Am J Gastroenterol 2013; 108: 1516-25.
Yang J, Deng Y, Chu H, et al. Prevalence and presentation of lactose intolerance and effects on dairy product intake in healthy subjects and patients with irritable bowel syndrome. Clin Gasrtoenterol Hepatol 2013; 11: 262-8.
Zhao J, Fox M, Cong Y, et al. Lactose intolerance in patients with chronic functional diarrhea: the role of small intestinal bacterial overgrowth. Aliment Pharmacol Ther 2010; 31: 892-900.
Holtung K, Clausen MR, Hove H, Christiansen J, Mortensen BP. The colon in carbohydrate malabsorption: short-chain fatty acids, pH, and osmotic diarrhoea. Scand J Gastroenterol 1992; 27: 545-52.
Carbonero F, Benefiel AC, Gaskins HR. Contributions of the microbial hydrogen economy to colonic homeostasis. Nat Rev Gastroenterol Hepatol 2012; 9: 504-18.
Madrid AM, Landskron G, Klapp G, Reyes A, Pizarro C, Defilippi C. Lactulose hydrogen breath test and functional symptoms in pediatric patients. Dig Dis Sci 2012; 57: 1330-5.
Ghoshal UC, Kumar S, Misra A, Mittal B. Lactose malabsorption diagnosed by 50-g dose is inferior to assess clinical intolerance and to predict response to milk withdrawal than 25-g dose in an endemic area. J Gastroenterol Hepatol 2013; 28: 1462-8.
Rana SV, Malik A. Hydrogen breath tests in gastrointestinal diseases. Ind J Clin Biochem 2014; 29: 398-405.
Casellas F, Malagelada JR. Applicability of short hydrogen breath test for screening of lactose malabsorption. Dig Dis Sci 2003; 48: 1333-8.
Bate JP, Irving PM, Barrett JS, Gibson PR. Benefits of breath hydrogen testing after lactulose administration in analysing carbohydrate malabsorption. Eur J Gastroenterol Hepatol 2010; 22: 318-26.
Dabritz J, Muhlbauer M, Domagk D, et al. Significance of hydrogen breath tests in children with suspected carbohydrate malabsorption. BMC Pediatrics 2014; 14: 59.
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