Submitted to: Pediatric Research
Publication Type: Abstract Only
Publication Acceptance Date: 3/1/2001
Publication Date: 4/1/2001
Citation: Karnsakul, W., Kitagawa, S., Olive, A., Villa, X., Sterchi, E.E., Hahn, D., Lugenbuehl, U., Nichols, B.L. 2001. Frequency of disaccharidase deficiencies in childhood chronic abdominal pain. Pediatric Research. 49:118A. Interpretive Summary: Interpretive Summary not needed for this 115.
Technical Abstract: BACKGROUND: Recurrent abdominal pain and discomfort are common symptoms in children. Childhood chronic abdominal pain (CCAP) is a poorly understood condition, which occasionally requires EGD. Endoscopy is performed to search for etiologies such as peptic ulcer disease. Lactose and sucrase-isomaltase deficiencies are known to cause diet associated abdominal complaints in some children. Disaccharide loading H2 breath tests of CCAP have yielded inconclusive results. OBJECTIVE: To determine frequency of disaccharidase deficiencies in CCAP. DESIGN/METHODS: Patients with abdominal pain for at least one month came were endoscoped. Enzyme assays were performed on jejunal biopsies with a modified Dahlqvist method using Polycose, sucrose, lactose, and maltose as substrates. Each study subject had normal villus length and villus-crypt ratio without increase of theliolymphocytes (Shiner criteria of <23%). RESULTS: Forty-one CCAP patients were endoscoped (47% F, 53% M; aged 11+/- 5 years). Low disaccharidase levels were found in 30%. Six had combined glucoamylase, sucrase, and lactase deficiencies (pandisaccharidase deficiencies). One had combined glucoamylase and sucrase deficiencies; five had isolated lactase deficiencies; and one had isolated sucrase deficiency. CONCLUSIONS: 30% of patients endoscoped for CCAP had one or more disaccharidase deficiencies. Pandisaccharidase deficiencies were present in half of this subgroup. Disaccharidase deficiencies may contribute to gastrointestinal complaints of 30% CCAP patients. Pandisaccharidase deficiencies may account for some of the difficulties in dietary management of CCAP.