A 15-year-old otherwise healthy boy presents with a complaint of intermittent abdominal distention, crampy abdominal pain, and excessive flatulence. He first started noticing these symptoms when he moved into his father’s house, and his stepmother insisted on milk at dinner every night. He has normal growth, has not lost weight, and has no travel history. Which of the following is the most appropriate diagnostic study to diagnose his condition?

a. Barium swallow and upper GI

b. Hydrogen excretion in breath after oral administration of lactose

c. Esophageal manometry

d. Stool pH

e. Serum lactose levels

the answer is below…

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