Literature DB >> 16609755

Hydrogen breath test for diagnosis of lactose malabsorption: the importance of timing and the number of breath samples.

Mauro Di Camillo1, Vanessa Marinaro, Fiorenza Argnani, Tiziana Foglietta, Piero Vernia.   

Abstract

BACKGROUND: The hydrogen breath test (H(2)BT) is the most widely used procedure in the diagnostic workup of lactose malabsorption and lactose intolerance. AIM: To establish whether a simplified two- or three-sample test may reduce time, costs and staff resources without reducing the sensitivity of the procedure. PATIENTS AND METHODS: Data from 1,112 patients (292 men, 820 women) with a positive 4 h, nine-sample H(2)BT were retrospectively analyzed. Patients were stratified according to the degree of lactose malabsorption, the occurrence and type of symptoms. Loss of sensitivity in the procedure was evaluated taking into account two-sample tests (0 min and 120 min or 0 min and 210 min) or three-sample tests (0 min, 120 min and 180 min or 0 min, 120 min and 210 min).
RESULTS: Using a two-sample test (0 min and 120 min or 0 min and 210 min) the false-negative rate was 33.4% and 22.7%, respectively. With a three-sample test (0 min, 120 min and 180 min or 0 min, 120 min or 210 min), lactose malabsorption was diagnosed in 91.2% (1,014 of 1,112) patients and in 96.1% (1,068 of 1,112) patients, respectively. Of 594 patients with abdominal symptoms, 158 (26.6%) and 73 (12.2%) would have false-negative results with 0 min and 120 min or 0 min and 210 min two-sample tests, respectively. The three-sample tests, 0 min, 120 min and 180 min or 0 min, 120 min and 210 min, have a false-negative rate of 5.9% and 2.1%, respectively.
CONCLUSIONS: A three-sample H(2)BT is time- and cost-sparing without significant loss of sensitivity for the diagnosis both of lactose malabsorption and lactose intolerance.

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Year:  2006        PMID: 16609755      PMCID: PMC2659903          DOI: 10.1155/2006/715459

Source DB:  PubMed          Journal:  Can J Gastroenterol        ISSN: 0835-7900            Impact factor:   3.522


  13 in total

1.  Hydrogen breath test in the diagnosis of lactose malabsorption: accuracy of new versus conventional criteria.

Authors:  Michele Di Stefano; Antonio Missanelli; Emanuela Miceli; Alessandra Strocchi; Gino Roberto Corazza
Journal:  J Lab Clin Med       Date:  2004-12

2.  Quality control study of H2 breath testing for the diagnosis of carbohydrate malabsorption in Italy. The "Tenue Club" Group.

Authors:  A Strocchi; G R Corazza; C Anania; G Benati; S Malservisi; M V Cherchi; M Certo; E Malorgio; M Marano; V Mazzeo; L Ginaldi; G M Giorgetti; T Pimpo; G Sciarretta; M Ventrucci; C Quondamcarlo; M A Pelli; F Perri
Journal:  Ital J Gastroenterol Hepatol       Date:  1997-04

3.  Two-hour lactose breath hydrogen test.

Authors:  T A Robb; G P Davidson
Journal:  J Pediatr Gastroenterol Nutr       Date:  1987 May-Jun       Impact factor: 2.839

4.  A standardized milk tolerance test.

Authors:  F P de Villiers
Journal:  J Clin Gastroenterol       Date:  1987-06       Impact factor: 3.062

5.  Methodology of the H2 breath test. II. Importance of the test duration in the diagnosis of carbohydrate malabsorption.

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Journal:  Ital J Gastroenterol       Date:  1990-10

6.  Applicability of short hydrogen breath test for screening of lactose malabsorption.

Authors:  F Casellas; J R Malagelada
Journal:  Dig Dis Sci       Date:  2003-07       Impact factor: 3.199

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Authors:  A Abramowitz; E Granot; I Tamir; R J Deckelbaum
Journal:  J Pediatr Gastroenterol Nutr       Date:  1986-01       Impact factor: 2.839

8.  Lactose malabsorption and intolerance in Italians. Clinical implications.

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Journal:  Dig Dis Sci       Date:  1986-12       Impact factor: 3.199

Review 9.  Lactose malabsorption. Optimalization of investigational methods.

Authors:  R J Brummer; M Karibe; R W Stockbrügger
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Review 10.  Genetics of lactase persistence and lactose intolerance.

Authors:  Dallas M Swallow
Journal:  Annu Rev Genet       Date:  2003       Impact factor: 16.830

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  7 in total

1.  Poor reproducibility of breath hydrogen testing: Implications for its application in functional bowel disorders.

Authors:  Chu K Yao; Caroline J Tuck; Jacqueline S Barrett; Kim Ek Canale; Hamish L Philpott; Peter R Gibson
Journal:  United European Gastroenterol J       Date:  2016-07-07       Impact factor: 4.623

2.  Four-sample lactose hydrogen breath test for diagnosis of lactose malabsorption in irritable bowel syndrome patients with diarrhea.

Authors:  Jian-Feng Yang; Mark Fox; Hua Chu; Xia Zheng; Yan-Qin Long; Daniel Pohl; Michael Fried; Ning Dai
Journal:  World J Gastroenterol       Date:  2015-06-28       Impact factor: 5.742

3.  A comparison of diagnostic tests for lactose malabsorption--which one is the best?

Authors:  Øistein Hovde; Per G Farup
Journal:  BMC Gastroenterol       Date:  2009-10-31       Impact factor: 3.067

4.  Application of medical gases in the field of neurobiology.

Authors:  Wenwu Liu; Nikan Khatibi; Aishwarya Sridharan; John H Zhang
Journal:  Med Gas Res       Date:  2011-06-27

5.  Fructose and lactose intolerance and malabsorption testing: the relationship with symptoms in functional gastrointestinal disorders.

Authors:  C H Wilder-Smith; A Materna; C Wermelinger; J Schuler
Journal:  Aliment Pharmacol Ther       Date:  2013-04-09       Impact factor: 8.171

Review 6.  Food intolerances and eosinophilic esophagitis in childhood.

Authors:  Oner Ozdemir; Emin Mete; Ferhat Catal; Duygu Ozol
Journal:  Dig Dis Sci       Date:  2008-07-02       Impact factor: 3.487

7.  Therapeutic antioxidant medical gas.

Authors:  Atsunori Nakao; Ryujiro Sugimoto; Timothy R Billiar; Kenneth R McCurry
Journal:  J Clin Biochem Nutr       Date:  2008-12-27       Impact factor: 3.114

  7 in total

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