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Fructose Malabsorption and Recurrent Abdominal Pain

May 19, 2014 7:00 am

Even before the popularity of a low FODMAPs diet, most pediatric gastroenterologists were aware that a significant number of children would develop pain if their diet included too much high fructose corn syrup. A recent study shows that a breath hydrogen test (BHT) for fructose malabsorption may predict patients who will improve with a low-fructose diet (JPGN 2014; 58: 498-501). Here’s a link to the abstract: goo.gl/10NYvm

Design: Retrospective study reviewed a single center experience. Fructose BHT (1 g/kg fructose to max of 25 g) was administered to 222 patients who presented with recurrent abdominal pain. An abnormal test was defined by a breath hydrogen >20 ppm over baseline. If positive, families met with a nutritionist for instruction on a low-fructose diet.

Key result: 121 of 222 (54.5%) had positive BHT. Of these 121 patients, 93 (77%) reported resolution of symptoms on a low-fructose diet. Among those with a negative BHT, 54% reported resolution of symptoms without a low-fructose diet.

Take-home message: High fructose corn syrup and fructose malabsorption can contribute to abdominal pain; though, in clinical practice, a BHT is not needed to institute a trial of a low-fructose diet.