RECURRENT ABDOMINAL-PAIN OF CHILDHOOD DUE TO LACTOSE-INTOLERANCE - PROSPECTIVE-STUDY

The role of lactose malabsorption was studied prospectively in 80 schoolchildren with recurrent abdominal pain. Malabsorption was documented in 40 per cent (16 of 59 whites, 12 of 16 blacks and four of five Hispanic children) on the basis of elevated levels of hydrogen in their breath. Those with lactose malabsorption, however, were not clinically distinguishable on the basis of past milk ingestion (P>0.05), weekly pain frequency (median, five vs. six times), presence of diarrhea (40 vs. 27 per cent) or Symptom response to lactose load. In children with malabsorption who completed a six-week diet trial, 70 per cent reported increased frequency of pain (P<0.002) when placed on their usual lactose-containing diet. Lactose malabsorption has a substantial role in the symptoms of children with recurrent abdominal pain, and it should be considered before performing invasive procedures or assuming a psychogenic origin. (N Engl J Med 300:1449–1452, 1979) RECURRENT abdominal pain usually indicates the presence of disease in otherwise healthy children. This paradox commonly leads the physician to search for underlying disease. Although about 10 per cent of children will have unexplained episodes of abdominal pain during their school years, a specific “organic” disease will be found in less than 10 per cent of those studied.1 In cases in which disease cannot be documented, a psychogenic or emotional basis is often invoked to explain the symptoms. This unsatisfactory situation stimulated a systematic search for factors unrelated to disease that might cause symptoms in such children. One factor is. © 1979, Massachusetts Medical Society. All rights reserved.