Results of the fructose breath test in healthy controls using different doses of fructose: which dose is best?

Doma, Siva; Gaddipati, Kishore; Fernández, Ángel Martínez; Friedenberg, Frank K.; Bromer, Matthew Q.; Parkman, Henry P.

doi:10.1016/s0002-9270(03)01570-3

Cited by 6 publications

(5 citation statements)

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“…However, this may be less appropriate in the scenario of fructose malabsorption, due to the variable absorption capacity of individuals. As testing in healthy adults has shown, a person who tests positive for malabsorption at 50 g of fructose may fully absorb the sugar and test negative when given 25 g of fructose . Sugar dose, therefore, has a strong influence on the fructose BHT result, and a high proportion of healthy children may test positive with the high doses of fructose commonly used in published studies .…”

Section: Resultsmentioning

confidence: 99%

“…Using a fixed dose, the proportion of those tested who showed incomplete fructose absorption on a BHT was strongly dependent on the size of the fructose dose given . Absorption capacity in healthy individuals has been more extensively studied in adults, with 58–87% of subjects testing positive with a 50 g dose of fructose, 10–53% testing positive with 25 g, and 0–10% testing positive with 15 g . An increasing proportion of positivity with increasing dose was also found in a study of children with persistent, unexplained abdominal pain when consuming 1 g (0 of 9 positive), 15 g (3 of 10 positive), and 45 g (8 of 13 positive) .…”

Section: Breath Hydrogen Testing Principles and Parametersmentioning

confidence: 90%

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Developmental changes and fructose absorption in children: effect on malabsorption testing and dietary management

et al. 2013

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Fructose malabsorption came to prominence in the pediatric arena as so-called "apple juice diarrhea," with excess consumption of fructose being linked to gastrointestinal symptoms such as diarrhea and abdominal pain. Over the past two decades the amount of fructose in children's diets has been increasing in the United States. A test for fructose malabsorption has yet to be fully validated, due mainly to the lack of an established etiology. In animal models, however, the fructose transporter GLUT5 is developmentally regulated, and this could be consistent with the greater susceptibility of children, especially toddlers, to fructose malabsorption. Additionally, the available evidence indicates the fructose breath hydrogen test has no apparent diagnostic utility in infants younger than 1 year; it may, therefore, be advisable to test for malabsorption by dietary exclusion in these patients. The present review aims to expound on the biological basis for fructose malabsorption in children and evaluate the current evidence for diagnostic procedures in order to identify clinical testing strategies that can be recommended and areas where further investigation is required.

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Section: Resultsmentioning

confidence: 99%

Section: Breath Hydrogen Testing Principles and Parametersmentioning

confidence: 90%

Developmental changes and fructose absorption in children: effect on malabsorption testing and dietary management

et al. 2013

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“…The proportion of malabsorption on the fructose breath test is dependent on the dose of fructose given. This effect has been more extensively studied in adults than in children; in healthy adults, 58% to 87% tested positive by the breath test when given a 50 grams dose of fructose, 10% to 53% tested positive with a 25 grams dose, and 0% to 10% with a 15 grams dose (4) . In healthy children, the effect of fructose dose on malabsorption has been shown in 0.1 to 6 year-olds; of whom 100% tested positive when challenged with a 2 g/bw dose, reducing to 44% positive with a 1 g/bw dose (9) .…”

Section: Discussionmentioning

confidence: 99%

“…Another pathway of fructose absorption occurs when it is ingested with glucose, by the mechanism called solvent drag, through the tight junctions of the enterocytes (24) . When the concentration of fructose in a certain food is present in excess of glucose concentration, condition very frequently observed in various juice fruits, mainly in apple, pear and grape juices, some individuals may develop fructose malabsorption (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)20) .…”

Section: Introductionmentioning

confidence: 99%

Fructose Malabsorption in Children With Functional Digestive Disorders

Lozinsky

Boé

Palmero

et al. 2013

Arq. Gastroenterol.

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-Context -Fructose is a monosaccharide frequently present in natural and artificial juice fruits. When the concentration of fructose in certain food is present in excess of glucose concentration some individuals may develop fructose malabsorption. Objectives -To report the frequency of fructose malabsorption utilizing the hydrogen breath test in children with gastrointestinal and/ or nutritional disorders. Methods -Between July 2011 and July 2012, 43 patients with gastrointestinal and/or nutritional disorders, from both sexes, were consecutively studied, utilizing the hydrogen breath test with loads of the following carbohydrates: lactose, glucose, fructose and lactulose. Fructose was offered in a 10% aqueous solution in the dose of 1 g/kg body weight. Samples were collected fasting and at every 15 minutes after the intake of the aqueous solution for a 2 hour period. Malabsorption was considered when there was an increase of >20 ppm of hydrogen over the fasting level, and intolerance was diagnosed if gastrointestinal symptoms would appear. Results -The age of the patients varied from 3 months to 16 years, 24 were boys. The following diagnosis were established: irritable bowel syndrome with diarrhea in 16, functional abdominal pain in 8, short stature in 10, lactose intolerance in 3, celiac disease in 1, food allergy in 1 and giardiasis in 1 patient. Fructose malabsorption was characterized in 13 (30.2%) patients, and intolerance in 1 (2.3%) patient. The most frequent fructose malabsorption was characterized in 7 (16.3%) patients with irritable bowel syndrome and in 4 (9.3%) patients with functional abdominal pain. Conclusions -Patients with irritable bowel syndrome and functional abdominal pain were the main cause of fructose malabsorption.

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“…In fact, the active reabsorption of glucose from the small intestine is due to the transport system SGLT-1/sodium-glucose cotransporter. When the ingested glucose is transported by SGLT1, GLUT2 is activated and inserted into the apical membrane, so the co-ingestion of glucose greatly enhances fructose absorption [ 58 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ]. A second mechanism has been postulated: fructose with other solutes is absorbed by a paracellular transport system, based on the opening of tight junctions induced by glucose absorption [ 58 ].…”

Section: Non-genetic Etiology Carbohydrate Intolerancesmentioning

confidence: 99%

Diagnosing and Treating Intolerance to Carbohydrates in Children

et al. 2016

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Intolerance to carbohydrates is relatively common in childhood, but still poorly recognized and managed. Over recent years it has come to the forefront because of progresses in our knowledge on the mechanisms and treatment of these conditions. Children with intolerance to carbohydrates often present with unexplained signs and symptoms. Here, we examine the most up-to-date research on these intolerances, discuss controversies relating to the diagnostic approach, including the role of molecular analysis, and provide new insights into modern management in the pediatric age, including the most recent evidence for correct dietary treatment.

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Results of the fructose breath test in healthy controls using different doses of fructose: which dose is best?

Cited by 6 publications

References 0 publications

Developmental changes and fructose absorption in children: effect on malabsorption testing and dietary management

Developmental changes and fructose absorption in children: effect on malabsorption testing and dietary management

Fructose Malabsorption in Children With Functional Digestive Disorders

Diagnosing and Treating Intolerance to Carbohydrates in Children

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