Benefits of breath hydrogen testing after lactulose administration in analysing carbohydrate malabsorption

被引:56
作者
Bate, John P.
Irving, Peter M.
Barrett, Jacqueline S.
Gibson, Peter R. [1 ]
机构
[1] Monash Univ, Dept Med, Box Hill Hosp, Box Hill, Vic 3128, Australia
关键词
breath test; fructose malabsorption; lactulose; small intestinal bacterial overgrowth; IRRITABLE-BOWEL-SYNDROME; INTESTINAL BACTERIAL OVERGROWTH; FRUCTOSE-MALABSORPTION; METHANE PRODUCTION; TRANSIT-TIME; OROCECAL TRANSIT; HEALTHY CONTROLS; NORMAL ADULTS; HUMAN-COLON; SYMPTOMS;
D O I
10.1097/MEG.0b013e32832b20e8
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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. Eur J Gastroenterol Hepatol 22: 318-326 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
引用
收藏
页码:318 / 326
页数:9
相关论文
共 50 条
[31]   A 14-day elemental diet is highly effective in normalizing the lactulose breath test [J].
Pimentel, M ;
Constantino, T ;
Kong, YT ;
Bajwa, M ;
Rezaei, A ;
Park, S .
DIGESTIVE DISEASES AND SCIENCES, 2004, 49 (01) :73-77
[32]   Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome: A double-blind, randomized, placebo-controlled study [J].
Pimentel, M ;
Chow, EJ ;
Lin, HC .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2003, 98 (02) :412-419
[33]   Methane production during lactulose breath test is associated with gastrointestinal disease presentation [J].
Pimentel, M ;
Mayer, AG ;
Park, S ;
Chow, EJ ;
Hasan, A ;
Kong, Y .
DIGESTIVE DISEASES AND SCIENCES, 2003, 48 (01) :86-92
[34]  
Pimentel M, 2000, AM J GASTROENTEROL, V95, P3503, DOI 10.1111/j.1572-0241.2000.03368.x
[35]   Ability of the normal human small intestine to absorb fructose: Evaluation by breath testing [J].
Rao, Satish S. C. ;
Attaluri, Ashok ;
Anderson, Leslie ;
Stumbo, Phyllis .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2007, 5 (08) :959-963
[36]  
RAVICH WJ, 1983, GASTROENTEROLOGY, V84, P26
[37]   LACTULOSE HYDROGEN BREATH TEST AS A DIAGNOSTIC-TEST FOR SMALL BOWEL BACTERIAL OVERGROWTH [J].
RHODES, JM ;
MIDDLETON, P ;
JEWELL, DP .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1979, 14 (03) :333-336
[38]  
Riordan SM, 1996, AM J GASTROENTEROL, V91, P1795
[39]   ABSORPTION CAPACITY OF FRUCTOSE IN HEALTHY-ADULTS - COMPARISON WITH SUCROSE AND ITS CONSTITUENT MONOSACCHARIDES [J].
RUMESSEN, JJ ;
GUDMANDHOYER, E .
GUT, 1986, 27 (10) :1161-1168
[40]   INTERVAL SAMPLING OF END-EXPIRATORY HYDROGEN (H-2) CONCENTRATIONS TO QUANTIFY CARBOHYDRATE MALABSORPTION BY MEANS OF LACTULOSE STANDARDS [J].
RUMESSEN, JJ ;
HAMBERG, O ;
GUDMANDHOYER, E .
GUT, 1990, 31 (01) :37-42