Journal of Clinical Pediatrics >
Analysis of clinical characteristics, endoscopic and pathological manifestations of children with positive lactulose hydrogen-methane breath test
Received date: 2025-02-13
Accepted date: 2025-04-28
Online published: 2025-06-01
Objective To summarize the application of the lactulose hydrogen-methane breath test (LHMBT) in children with gastrointestinal discomfort, and to analyze the clinical and endoscopic features of children with positive LHMBT. Methods A retrospective analysis was conducted on the clinical data of children hospitalized due to gastrointestinal discomfort in the Department of Gastroenterology of Shanghai Children's Hospital from August 2021 to October 2022. According to the LHMBT results, the children were classified into the LHMBT positive group and the LHMBT negative group, and the clinical characteristics of the two groups were compared. Among them, 63 children underwent gastrointestinal endoscopy, and their endoscopic and histopathological characteristics were analyzed. Results A total of 124 children with gastrointestinal discomfort were included, including 62 boys and 62 girls, with a median age of 10.0 (7.5-12.7) years. LHMBT was positive in 85 (68.5%) children. Among them, the positive rate of SIBO was 24.2% (30/124), the positive rate of IMO was 63.7% (79/124), and the co-positive rate of SIBO and IMO was 19.4% (24/124). The age distribution between the LHMBT positive and negative groups was statistically significant (P<0.05). The proportion of those aged 12-18 years in the LHMBT positive group was relatively low. Among the gastrointestinal discomfort symptoms of the children, abdominal pain was the most common (67.7%, 84/124), followed by abdominal distension (25.0%, 31/124) and constipation (18.5%, 23/124). Compared with the LHMBT-negative group, the proportion of children with diarrhea in the LHMBT-positive group was lower, and the difference was statistically significant (P<0.05). Among the 63 children who underwent gastrointestinal endoscopy, villous blunting and crypt loss in the terminal ileum were more frequently observed in the LHMBT positive group (n=47) than that in the LHMBT negative group (n=16), and the difference was statistically significant (P<0.05). Conclusions The positive rate of LHMBT in children with gastrointestinal discomfort is high, and the incidence of IMO is higher than that of SIBO. LHMBT positivity might correlates with villous blunting and crypt loss in the terminal ileum.
WANG Ruixue , WANG Runjie , LI Xiaolu , ZHANG Ting , XIAO Yongmei . Analysis of clinical characteristics, endoscopic and pathological manifestations of children with positive lactulose hydrogen-methane breath test[J]. Journal of Clinical Pediatrics, 2025 , 43(6) : 418 -425 . DOI: 10.12372/jcp.2025.25e0105
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