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FRUIT-JUICE AND DIARRHEA.

Juices are often included in clear-liquid regimens for acute or chronic diarrhea in young children, despite an association between apple juice and chronic nonspecific diarrhea (which results from carbohydrate malabsorption). Hyams and colleagues questioned how frequently carbohydrate malabsorption occurs after the ingestion of other fruit juices and whether sorbitol, a natural sugar alcohol, also has a role in malabsorption.

The investigators studied 20 children under three years of age: seven with a three-month history of chronic nonspecific diarrhea and 13 healthy controls. Breath hydrogen was measured to detect carbohydrate malabsorption after ingestion of pear, apple, and grape juices and a 2 percent sorbitol solution. In addition, the authors assessed symptoms of diarrhea, bloating, and abdominal pain during eight hours after ingestion. There were no significant differences in the mean increase in breath hydrogen between the two study groups; however, in both groups there were significant differences in the response to the different juices. An increase in breath hydrogen excretion was observed in all children after they drank pear juice or the 2 percent sorbitol solution, in approximately half after consumption of apple juice, and in one-fourth after grape juice. Gastrointestinal symptoms occurred in more than 30 percent of children consuming pear juice, apple juice, and sorbitol, but in only 10 percent of those drinking grape juice. Chronic nonspecific diarrhea resolved in three of the seven children after fruit juices were eliminated from their diets. These data suggest that carbohydrate malabsorption after fruit-juice ingestion is common and that these juices may perpetuate symptoms in certain children with diarrhea.

— PMM

Published in Journal Watch General Medicine July 22, 1988

Citation(s):

Hyams J S; Etienne N L; Leichtner A M; Theuer R C. Carbohydrate malabsorption following fruit juice ingestion in young children. Pediatrics 1988 Jul 82 64-68.

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