ABDOMINAL-PAIN IN CHILDREN DUE TO LACTOSE-INTOLERANCE - PROSPECTIVE BREATH HYDROGEN TEST

Objectives: We performed the breath hydrogen test in children consulti ng for abdominal pain in order to determine the minimal quantity of la ctose required to prove malabsorption with least patient incomfort and to evaluate the effect of an adapted diet in children with a positive test. Methods: The breath hydrogen test after lactose intake was perf ormed in 109 children (51 boys, 58 girls, mean age 8.2 + 3.2 years, ra nge 3 to 15) seen for unexplained abdominal pain. All these children h ad complained of abdominal pain daily for at least 6 months and no oth er 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. Results: The diagnosis of la ctose intolerance was established in 83 children (76.1%) on the basis of a hydrogen peak in the breath after lactose ingestion. One-fourth o f the children were of French origin and the others had at least one g randparent 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%. Conclusion: The breath hydrogen test is a simple non-invasive test which allows a selection of children wh o could benefit from a lactose-free diet although it cannot be used to predict the effect of diet.