{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:16:52Z","timestamp":1784161012922,"version":"3.55.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T00:00:00Z","timestamp":1580774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tests for stool reducing sugars and stool pH are ordered for children with osmotic diarrhea to screen for carbohydrate malabsorption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared the results of the two screening tests, stool reducing sugars and stool pH, with a more definitive result from an intestinal tissue disaccharidase activity assay ordered for pediatric patients (&amp;lt;18\u2009years old). Overall, 159 patients had results for tissue disaccharidase and stool reducing sugars, but only 115 had additional results of stool pH. Forty-six of the 159 patients had mild, moderate, or severe disaccharidase deficiencies. The sensitivity and specificity of the screening tests were calculated for individual disaccharidase deficiencies. In addition, trends of abnormal tissue disaccharidase, stool reducing sugars, and stool pH results were examined in different age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sensitivities for stool reducing sugars and stool pH were 9% to 28% and specificities were 74% to 81% for individual disaccharidase deficiencies. Infants (0\u2009years of age) had the highest percentage of abnormal results across all three tests; however, the positive predicative values were 54% and 50% for stool reducing sugars and stool pH, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The screening tests, stool reducing sugars and stool pH, had low sensitivity compared with results of measured tissue disaccharidase activity in pediatric patients. Infants had the highest percentage of abnormal results for all three tests, but the screening tests still performed poorly in that age group. This study suggests that stool reducing sugars and stool pH should not be used as screening tests for carbohydrate malabsorption due to disaccharidase deficiencies in pediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jalm\/jfz017","type":"journal-article","created":{"date-parts":[[2020,1,2]],"date-time":"2020-01-02T20:08:15Z","timestamp":1577995695000},"page":"257-262","source":"Crossref","is-referenced-by-count":11,"title":["Stool Reducing Sugars and Stool pH Are Poor Screening Tests for Intestinal Disaccharidase Deficiencies in Children"],"prefix":"10.1093","volume":"5","author":[{"given":"J Alan","family":"Erickson","sequence":"first","affiliation":[{"name":"ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Case","sequence":"first","affiliation":[{"name":"ARUP Laboratories, Salt Lake City, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cole","family":"Neider","sequence":"first","affiliation":[{"name":"ARUP Laboratories, Salt Lake City, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M","family":"Johnson","sequence":"first","affiliation":[{"name":"ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT"},{"name":"ARUP Laboratories, Salt Lake City, UT"},{"name":"Department of Pathology, University of Utah, Salt Lake City, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,4]]},"reference":[{"key":"2020030410400461000_jfz017-B1","doi-asserted-by":"crossref","first-page":"981.","DOI":"10.1016\/S0140-6736(64)91777-5","article-title":"A ward test for sugar in feces","volume":"1","author":"Kerry","year":"1964","journal-title":"Lancet"},{"key":"2020030410400461000_jfz017-B2","first-page":"1831","volume-title":"Nelson textbook of pediatrics.","author":"Branski","year":"2016","edition":"20th Ed"},{"key":"2020030410400461000_jfz017-B3","author":"Kellermayer"},{"key":"2020030410400461000_jfz017-B4","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1136\/adc.48.5.331","article-title":"Sugar-induced diarrhoea in children","volume":"48","author":"Gracey","year":"1973","journal-title":"Arch Dis Childhood"},{"key":"2020030410400461000_jfz017-B5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.3109\/00365518409161400","article-title":"Assay of intestinal disaccharidases","volume":"44","author":"Dahlqvist","year":"1984","journal-title":"Scand J Clin Lab Invest"},{"key":"2020030410400461000_jfz017-B6","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1373\/jalm.2016.020388","article-title":"Reference intervals for intestinal disaccharidase activities determined from a non-reference population","volume":"1","author":"Hackenmueller","year":"2016","journal-title":"J App Lab Med"},{"key":"2020030410400461000_jfz017-B7","first-page":"37","article-title":"Clinitesting neonatal stools","volume":"8","author":"Krom","year":"1989","journal-title":"Neonatal Netw"},{"key":"2020030410400461000_jfz017-B8","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.cca.2010.02.009","article-title":"High-throughput tissue homogenization method and tissue-based quality control materials for a clinical assay of the intestinal disaccharidases","volume":"411","author":"Lu","year":"2010","journal-title":"Clin Chim Acta"},{"key":"2020030410400461000_jfz017-B9","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1542\/peds.46.4.632","article-title":"Reducing substances in neonatal stools detected by Clinitest","volume":"46","author":"Davidson","year":"1970","journal-title":"Pediatrics"},{"key":"2020030410400461000_jfz017-B10","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1136\/adc.51.7.517","article-title":"Stool and urinary sugars in normal neonates","volume":"51","author":"Counahan","year":"1976","journal-title":"Arch Dis Childhood"},{"key":"2020030410400461000_jfz017-B11","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1097\/00005176-199101000-00017","article-title":". Epidemiologic, clinical, and laboratory characteristics of acute vs. persistent diarrhea in Periurban Lima, Peru","volume":"12","author":"Lanata","year":"1991","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020030410400461000_jfz017-B12","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1651-2227.1992.tb12387.x","article-title":"Lactose feeding during persistent diarrhoea","volume":"381","author":"Penny","year":"1992","journal-title":"Acta Paediatr Suppl"},{"key":"2020030410400461000_jfz017-B13","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S1536-0903(03)00073-0","article-title":"A critical analysis of the routine testing of newborn stools for occult blood and reducing substances","volume":"3","author":"Pinheiro","year":"2003","journal-title":"Adv Neonatal Care"},{"key":"2020030410400461000_jfz017-B14","first-page":"424","volume-title":"Manual of pediatric nutrition","author":"Brenn","year":"2014","edition":"5th Ed"},{"key":"2020030410400461000_jfz017-B15","doi-asserted-by":"crossref","first-page":"611.","DOI":"10.1136\/adc.2010.205237","article-title":"Lactose intolerance in infants: harder to investigate now following discontinuation of Clinitest","volume":"96","author":"Chong","year":"2011","journal-title":"Arch Dis Child"},{"key":"2020030410400461000_jfz017-B16","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1097\/00005176-198302030-00016","article-title":"Fecal reducing substances and breath hydrogen excretion as indicators of carbohydrate malabsorption","volume":"2","author":"Caballero","year":"1983","journal-title":"J Pediatr Gastroenterol Nutr"}],"container-title":["The Journal of Applied Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jalm\/article-pdf\/5\/2\/257\/32784586\/jfz017.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jalm\/article-pdf\/5\/2\/257\/32784586\/jfz017.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,9]],"date-time":"2022-10-09T19:25:45Z","timestamp":1665343545000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jalm\/article\/5\/2\/257\/5780324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,4]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,4]]},"published-print":{"date-parts":[[2020,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jalm\/jfz017","relation":{},"ISSN":["2576-9456","2475-7241"],"issn-type":[{"value":"2576-9456","type":"print"},{"value":"2475-7241","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,3]]},"published":{"date-parts":[[2020,2,4]]}}}