FRUCTOSE BREATH HYDROGEN TESTS IN INFANTS WITH CHRONIC NONSPECIFIC DIARRHEA

Clear fluids high in fructose (e.g., apple juice) have been incriminat ed for symptoms of chronic non-specific diarrhoea (CNSD:). in particul ar in children 1-4 years of age. H-2 breath tests were performed, afte r ingestion of fructose (I g/kg), in 15 patients referred with CNSD an d 35 controls. All 15 CNSD children (100%) had breath peak H-2 of grea ter than or equal to 20 ppm versus 49% of the 35 controls (P = 0.0005) . Median peak H-2 in CNSD (90 ppm, range 31-136) was significantly hig her than in controls (20 ppm, range 1-139) (P < 0.001). Orocoecal tran sit time in children with positive tests was similar in both groups. S imilary, median H-2 increases during the test period had the same dist ribution. We demonstrated fructose malabsorption in CNSD, but found a great overlap with the control group. Our results strongly discourage the use of fructose breath H-2 tests in children suspected of CNSD. A positive test has no diagnostic value and a negative test has no clini cal implications. Conclusion For clinical practice, we suggest a dieta ry history and a trial of appropriate measures in infants with chronic nonspecific diarrhoea, instead of performing the fructose H-2 breath test.