Hydrogen breath test

Of the indirect tests the 13C or 14C-d-xylose or lactulose breath test and the glucose, lactose or lactulose hydrogen breath tests are available alternatives. These tests are in general developed to recognize Gram-negative bacilli rather than URT overgrowth. There are, however, pitfalls involved. 

Furthermore, similar glucose hydrogen breath tests in the elderly with and without omeprazole [76] and normal 14C-r/-xylose breath test in healthy old people with acquired gastric hypochlorhydria (pH >6) [32] counterindi-cate that H2 blockers induce colonization with strict anaerobes of intestinal types (colonic flora) in the upper gut. 

Studies of small bowel transit time have demonstrated a great variability both within and between individuals. When the hydrogen breath test was performed under fasting conditions, using 10 ml of lactulose, the coefficient of variation amounted to 18%. Di Lorenzo et al. [129] showed that variations under fasting conditions are partly accounted for by the phase of the migrating motor complex at the intake of test solution. Moreover, when a lactose-containing meal was used, the coefficient of variation was reduced to 4% [130],... 

Hutchinson S, Fogan R The effect of long-term omeprazole on the glucose-hydrogen breath test in elderly patients. Age Ageing 1997 26 87-89. 

Di Lorenzo C, Dooley CP, Valenzula JE Role of fasting gastrointestinal motility in the variability of gastrointestinal transit time assessed by hydrogen breath test. Gut 1991 32 1127-1130. 

In addition to ANP where it is associated with GI dys-motility [198, 199], SIBO is present in a significant proportion of patients with chronic pancreatitis [200, 201], Short-term rifaximin therapy was able to normalize the hydrogen breath test and improve symptoms (i.e. diarrhea and fecal fat excretion) in all patients studied (fig. 9) [201]. Bowel decontamination via administration of this topical antibiotic could, therefore, be beneficial in both acute and chronic pancreatitis. Double-blind, placebo-controlled studies are to be performed to explore the rifaximin potential in this indication. 

Gastrointestinal transit time by hydrogen breath test and radio-opaque markers Gastrointestinal motiUty agents... 

TABLE 48-6 Reported Sensitivity and Specificity of Lactulose and Glucose Hydrogen Breath Tests for the Diagnosis of Bacterial Overgrowth... 

The diagnostic gold standard requires intubation with aspiration of jejunal contents and the demonstration of a bacterial count of >10 organisms/mL and >10 anaer-obes/mL. In practice, hydrogen breath tests using eitiier lactulose or glucose as substrates are used more frequently. An alternative diagnostic approach is to use a therapeutic trial of antibiotics. 

Mastropaoio G, Rees WDW. Evaluation of the hydrogen breath test in man definition and ehmination of the early hydrogen peak. Gut 1987 28 721-5. 

Rhodes JM, Middleton P, Jewell DP. The Lactulose hydrogen breath test as a diagnostic test for smaU-bowel bacterial overgrowth. Scand J Gastroenterol 1979 14 333-6. 

Watts D, Brydon G, Crichton S, Ghosh S, Glucose hydrogen breath test in the investigation of diarrhoea. Gut 2000 46(suppl I1) A23. 

Hydrogen breath test Assesses bacterial overgrowth in the intestine... 

A report from Sweden (Rasic and Kurmann, 1978) indicated that nine out of 11 lactose-intolerant individuals tolerated yogurt. Nichols (1978) administered acidophilus milk (5 ml/kg/d) to six lactase-deficient subjects. On the basis of hydrogen breath test results, it was concluded that Lactobacillus acidophilus did not promote additional lactose hydrolysis. However, the dose of microorganisms (2-4 x 10 /ml) used in this study is much lower than typical counts in fermented milk products. From the same laboratory (Gilliland and Kim, 1981), it was later reported that administration of acidophilus milk containing more natural numbers resulted in decreased breath hydrogen production by lactose-intolerant individuals. 

Motility Absence of vomiting, stool pattern, growth velocity Measurements of transit times (e.g., charcoal, hydrogen breath tests)... 

Maffei HV, Metz G, Bampoe V, Shiner M, Herman S, Brook CG. 1977. Lactose intolerance, detected by the hydrogen breath test, in infants and children with chronic diarrhoea. Arch Dis Child 52 766-767. 

Biofermented yoghurt contains a higher lactose content than fresh milk d. True lactase deficiency can be confirmed by the hydrogen breath test c. Temporary secondary lactose intolerance may occur after a severe gastrointestinal infection... 

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