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Benefits of breath hydrogen testing after lactulose administration in analysing carbohydrate malabsorption.
Eur J Gastroenterol Hepatol. 2010 Mar; 22(3):318-26.EJ

Abstract

BACKGROUND AND AIMS

Breath hydrogen testing after lactulose administration may yield findings of clinical value, but whether it should be a routine part of breath testing has not been evaluated. We examined the contribution of breath testing after lactulose administration to the conduct and interpretation of breath hydrogen responses after fructose and lactose administration.

METHODS

Two hundred consecutive patients were given lactulose, fructose or lactose on separate days (at least 2 days apart); breath hydrogen was monitored every 15 min after the administration of each sugar.

RESULTS

Peak breath hydrogen levels after lactulose administration correlated with those after fructose (r = 0.26; P = 0.03) and lactose (r = 0.44; P = 0.004). Of the patients with a reduced response to lactulose, 51% had definite or borderline evidence of fructose malabsorption (FM); similarly, 23% of patients had definite or borderline lactose malabsorption. After lactulose administration, an increase in breath hydrogen levels occurred after the same amount of time or longer than after the administration of fructose or lactose (>120 min). The earlier the first rise in breath hydrogen levels after lactulose administration, the more frequently FM occurred, indicating an association between FM and rapid transit and/or small intestinal bacterial overgrowth.

CONCLUSION

Routine breath hydrogen testing with lactulose administration before other sugars cannot be used to define non-hydrogen producers, but might, by indicating the vigour of hydrogen production in the individual, allow more rational interpretation of results after testing with other sugars. It permits the duration of testing to be judged and provides information on possible mechanisms of FM.

Authors+Show Affiliations

Departments of Medicine and Gastroenterology, Monash University, Box Hill Hospital, Box Hill, Victoria, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19636251

Citation

Bate, John P., et al. "Benefits of Breath Hydrogen Testing After Lactulose Administration in Analysing Carbohydrate Malabsorption." European Journal of Gastroenterology & Hepatology, vol. 22, no. 3, 2010, pp. 318-26.
Bate JP, Irving PM, Barrett JS, et al. Benefits of breath hydrogen testing after lactulose administration in analysing carbohydrate malabsorption. Eur J Gastroenterol Hepatol. 2010;22(3):318-26.
Bate, J. P., Irving, P. M., Barrett, J. S., & Gibson, P. R. (2010). Benefits of breath hydrogen testing after lactulose administration in analysing carbohydrate malabsorption. European Journal of Gastroenterology & Hepatology, 22(3), 318-26. https://doi.org/10.1097/MEG.0b013e32832b20e8
Bate JP, et al. Benefits of Breath Hydrogen Testing After Lactulose Administration in Analysing Carbohydrate Malabsorption. Eur J Gastroenterol Hepatol. 2010;22(3):318-26. PubMed PMID: 19636251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Benefits of breath hydrogen testing after lactulose administration in analysing carbohydrate malabsorption. AU - Bate,John P, AU - Irving,Peter M, AU - Barrett,Jacqueline S, AU - Gibson,Peter R, PY - 2009/7/29/entrez PY - 2009/7/29/pubmed PY - 2010/4/29/medline SP - 318 EP - 26 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 22 IS - 3 N2 - BACKGROUND AND AIMS: Breath hydrogen testing after lactulose administration may yield findings of clinical value, but whether it should be a routine part of breath testing has not been evaluated. We examined the contribution of breath testing after lactulose administration to the conduct and interpretation of breath hydrogen responses after fructose and lactose administration. METHODS: Two hundred consecutive patients were given lactulose, fructose or lactose on separate days (at least 2 days apart); breath hydrogen was monitored every 15 min after the administration of each sugar. RESULTS: Peak breath hydrogen levels after lactulose administration correlated with those after fructose (r = 0.26; P = 0.03) and lactose (r = 0.44; P = 0.004). Of the patients with a reduced response to lactulose, 51% had definite or borderline evidence of fructose malabsorption (FM); similarly, 23% of patients had definite or borderline lactose malabsorption. After lactulose administration, an increase in breath hydrogen levels occurred after the same amount of time or longer than after the administration of fructose or lactose (>120 min). The earlier the first rise in breath hydrogen levels after lactulose administration, the more frequently FM occurred, indicating an association between FM and rapid transit and/or small intestinal bacterial overgrowth. CONCLUSION: Routine breath hydrogen testing with lactulose administration before other sugars cannot be used to define non-hydrogen producers, but might, by indicating the vigour of hydrogen production in the individual, allow more rational interpretation of results after testing with other sugars. It permits the duration of testing to be judged and provides information on possible mechanisms of FM. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/19636251/Benefits_of_breath_hydrogen_testing_after_lactulose_administration_in_analysing_carbohydrate_malabsorption_ L2 - https://doi.org/10.1097/MEG.0b013e32832b20e8 DB - PRIME DP - Unbound Medicine ER -