Hydrogen and Methane Breath Test in the Diagnosis of Lactose Intolerance

The hydrogen (H2) breath test is a non-invasive investigation used to diagnose lactose intolerance (LI). Patients with LI may also expire increased amounts of methane (CH4) during a lactose test. The aim of this study is to evaluate the contribution of CH4 measurements. We tested 209 children (1–17 years old) with symptoms suggesting LI with lactose H2 and CH4 breath tests. The result was positive when the H2 excretion exceeded 20 parts per million (ppm) and the CH4 was 10 ppm above the baseline. A clinician, blinded for the results of the breath test, registered the symptoms. Of the patient population, 101/209 (48%) were negative for both H2 and CH4; 96/209 (46%) had a positive H2 breath test result; 31/96 (32%) were also positive for CH4; 12/209 (6%) patients were only positive for CH4. The majority of hydrogen producers showed symptoms, whereas this was only the case in half of the H2-negative CH4 producers. Almost all patients treated with a lactose-poor diet reported significant symptom improvement. These results indicate that CH4 measurements may possibly be of additional value for the diagnosis of LI, since 5.7% of patients were negative for H2 and positive for CH4, and half of them experienced symptoms during the test.

Download Full-text

Increasing Expiratory Hydrogen in Lactose Intolerance Is Associated with Additional Food Intolerance/Malabsorption

Nutrients ◽

10.3390/nu12123690 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3690

Author(s):

Wolfgang J. Schnedl ◽

Nathalie Meier-Allard ◽

Sonja Lackner ◽

Dietmar Enko ◽

Harald Mangge ◽

...

Keyword(s):

Diamine Oxidase ◽

Lactose Intolerance ◽

Area Under The Curve ◽

Pairwise Comparison ◽

Food Intolerance ◽

Additional Food ◽

Breath Tests ◽

Fructose Malabsorption ◽

Significant Difference ◽

H2 Breath Test

Single and/or combined food intolerance/malabsorption may cause nonspecific, functional gastrointestinal (GI) complaints. In lactose-intolerant patients we evaluated the influence of additional food intolerance/malabsorption with hydrogen (H2) breath tests. In a retrospective analysis of charts from 279 lactose-intolerant patients, we found 128 patients with only lactose intolerance (LIT). Then, we identified 106 LIT patients with additional histamine intolerance (HIT). Additionally, 45 LIT and HIT patients also had fructose malabsorption (FM). A hydrogen (H2) breath test was performed to evaluate LIT and FM. A serum diamine oxidase value of <10 U/mL and a response to a histamine-reduced diet was used to identify HIT. Using pairwise comparison with the Kruskal–Wallis test to associate the area under the curve (AUC) of LIT patients and, LIT with HIT, to LIT with HIT and FM it was found, that the exhaled hydrogen values were significantly higher in patients with two-fold and triple combined food intolerance/malabsorption (p < 0.004 and p < 0.001, respectively). Within the pool of 170 LIT patients with >20 ppm increase of expiratory H2 from baseline, there were 74 LIT-only patients, 60 LIT with HIT patients, and 36 LIT patients with additional HIT and FM. With the Kruskal–Wallis test AUCs demonstrated a significant difference between all three groups (p = 0.024). In patients with LIT, the presence of additional food intolerance/malabsorption, significantly increases expiratory H2 values. We demonstrate evidence, which may suggest HIT to embody an own GI disorder as food intolerance/malabsorption.

Download Full-text

Breathing tests and their significance in the clinic of internal diseases: the importance of non-invasive 13C bicarbonate breath test in medical diagnostics.

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2018-96-4-309-313 ◽

2018 ◽

Vol 96 (4) ◽

pp. 309-313

Author(s):

S. I. Rapoport ◽

A. M. Zyakun ◽

Nina A. Shubina

Keyword(s):

Helicobacter Pylori ◽

Breath Test ◽

Developed Countries ◽

Medical Diagnostics ◽

Breath Tests ◽

Non Invasive ◽

The World

13C breath tests have been widely developed in the world gastroenterology at the beginning of the 90-ies of the last century. This technique has been used for over 20 years in many developed countries and it has long been a routine and mass procedure. 13C urease breath test for infection Helicobacter pylori detection is the most widely analysis among 13C breath tests. Researchers are developing new 13C-biomarkers and expand the list of available substrates. One of these techniques is a multifunctional 13C bicarbonate breath test. Here is a brief overview of this application.

Download Full-text

Knowledge of lactose intolerance among clinicians

Gastroenterology Insights ◽

10.4081/gi.2018.7740 ◽

2018 ◽

Vol 9 (1) ◽

Author(s):

Nebras Ebrahim Hasan ◽

Manal Hasan Zainaldeen ◽

Fatima Abdulameer Almadhoob ◽

Manaf Ali Yusuf ◽

Salim Fredericks

Keyword(s):

Differential Diagnosis ◽

Breath Test ◽

Lactose Intolerance ◽

Hydrogen Breath Test ◽

Breath Tests ◽

Medical Practitioners ◽

Medical Specialists ◽

Diagnostic Aspects ◽

Significant Difference ◽

Hydrogen Breath Tests

Lactose intolerance is associated with the inability to digest significant amounts of lactose. Several conditions have symptoms that overlap with those of lactose intolerance. Thus, it is commonly misdiagnosed. There are established investigation procedures that aid diagnosis which include the lactose challenge and the hydrogen breath tests. However, differential diagnosis remains challenging. We aimed at identifying gaps in knowledge regarding lactose intolerance among medical practitioners using a survey consisting of 15 questions. It was completed by 98 doctors. Most questions were answered correctly by more than half of the participants. There was no significant difference in the frequency of correct answers between the different medical specialists or age of participating doctors. Crucially, one question relating to the hydrogen breath test was answered incorrectly by 85% of the participants. This highlights acceptable knowledge of general issues, but not the diagnostic aspects, of lactose intolerance among doctors.

Download Full-text