[Breath tests in children with suspected lactose intolerance]. / Análisis de test de aire espirado en niños con sospecha de intolerancia a la lactosa.

INTRODUCTION: Up to 70% of the world population is lactose intolerance. However, there are no epidemiological studies among Chilean pediatric population affected by this condition. OBJECTIVES: Clinical characterization of a series of children who underwent the lactose intolerance breath test for lactose intolerance study, establishing intolerance and malabsorption frequencies, the most frequent symptoms, and test performance depending on the origin. PATIENTS AND METHODS: Patients under 18 years old who took the lactose intolerance breath test in the Gastroenterology Laboratory of the Catholic University of Chile, and who were admitted due to clinically suspected lactose intolerance. Malabsorption was considered when there was as an increase of ≥20ppm above the baseline (H2) or ≥34ppm of H2 and methane (CH4) combined. Intolerance was considered when the above was associated with a symptom intensity score ≥7 during registration. RESULTS: The analysis included194 patients aged 1 to17 years of age. Of these, 102 (53%) presented with malabsorption, and 53 (27%) were intolerant. The frequency of lactose intolerance varied from 7.1 to 45.4%, and it occurred more frequently at older ages. The most common reported symptoms were abdominal pain, bloating and rumbling. DISCUSSION: Lactose malabsorption and intolerance can be investigated from the first years of life using the lactose breath test plus a symptom questionnaire. An increase in the frequency of intolerance with age, and a greater number of positive tests, if they were requested by a gastroenterologist, were observed.

Análisis de test de aire espirado en niños con sospecha de intolerancia a la lactosa / Breath tests in children with suspected lactose intolerance

Introducción: Un 70% de la población general presenta intolerancia a la lactosa; sin embargo, no existen estudios epidemiológicos en la población pediátrica chilena afectada por esta condición. Objetivos: Caracterizar una serie clínica de niños que acude a realizarse el test de aire espirado con lactosa para estudio de intolerancia a la lactosa, determinando la frecuencia de intolerancia y malabsorción, síntomas más frecuentes y rendimiento del test dependiendo de su origen. Pacientes y Método: Pacientes menores de 18 años que acudieron a realizarse el test de aire espirado con lactosa al Laboratorio de Gastroenterología de la Pontificia Universidad Católica de Chile, por sospecha clínica de intolerancia a la lactosa. Se consideró malabsorción un aumento ≥ 20 ppm sobre el nivel basal de hidrógeno (H2) o ≥ 34 ppm de H2 y metano (CH4) en conjunto y como intolerancia cuando lo anterior se asoció a la sumatoria de intensidad de síntomas ≥ 7 en el registro. Resultados: Se analizaron 194 pacientes entre 1 y 17 años de edad. De ellos, 102 (53%) pacientes resultaron malabsorbedores y 53 (27%) intolerantes. La frecuencia de intolerancia a la lactosa varió de un 7,1 a un 45,4%, con una mayor frecuencia a edades mayores. Los síntomas más reportados fueron dolor abdominal, meteorismo y borborigmo. Discusión: La malabsorción e intolerancia a lactosa se pueden pesquisar desde los primeros años de vida utilizando el test de aire espirado con lactosa asociado al cuestionario simultáneo de síntomas. Se puede observar un aumento en la frecuencia de intolerancia con la edad, además de una mayor positividad del examen si es solicitado por un gastroenterólogo.

Introduction: Up to 70% of the world population is lactose intolerance. However, there are no epidemiological studies among Chilean pediatric population affected by this condition. Objectives: Clinical characterization of a series of children who underwent the lactose intolerance breath test for lactose intolerance study, establishing intolerance and malabsorption frequencies, the most frequent symptoms, and test performance depending on the origin. Patients and Methods: Patients under 18 years old who took the lactose intolerance breath test in the Gastroenterology Laboratory of the Catholic University of Chile, and who were admitted due to clinically suspected lactose intolerance. Malabsorption was considered when there was as an increase of ≥ 20 ppm above the baseline (H2) or ≥ 34 ppm of H2 and methane (CH4) combined. Intolerance was considered when the above was associated with a symptom intensity score ≥ 7 during registration. Results: The analysis included194 patients aged 1 to17 years of age. Of these, 102 (53%) presented with malabsorption, and 53 (27%) were intolerant. The frequency of lactose intolerance varied from 7.1 to 45.4%, and it occurred more frequently at older ages. The most common reported symptoms were abdominal pain, bloating and rumbling. Discussion: Lactose malabsorption and intolerance can be investigated from the first years of life using the lactose breath test plus a symptom questionnaire. An increase in the frequency of intolerance with age, and a greater number of positive tests, if they were requested by a gastroenterologist, were observed.