scholarly journals Knowledge of lactose intolerance among clinicians

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.

scholarly journals Lactose Intolerance: What Your Breath Can Tell You

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 412
Author(s):  
Luelle Robles ◽  
Ronny Priefer
Keyword(s):  
Gastrointestinal Tract ◽  
Lactose Intolerance ◽  
Low Cost ◽  
Intestinal Flora ◽  
Clinical Syndrome ◽  
Gi Tract ◽  
Hydrogen Breath Test ◽  
Breath Tests ◽  
Novel Approaches ◽  
Blood Biopsy

Lactose intolerance has seen recognized as a clinical syndrome characterized by pain, abdominal distention, flatulence, and diarrhea after the consumption of lactose. Lactose is a common disaccharide found in dairy that requires lactase-phlorizin hydrolase (LPH) to break down into glucose and galactose. A deficiency in this enzyme results in flora bacteria further along in the gastrointestinal tract (GI) tract to metabolize the excess lactose to numerous gases, including H2. Recent studies show that the risk of symptoms after lactose ingestion depends on the dose of lactose, LPH expression, intestinal flora, and sensitivity of the gastrointestinal tract. Currently, there are several diagnostic tests that investigate the biological mechanism of lactose intolerance such as blood, biopsy, genetic, and breath tests. Due to its relatively low cost, availability, and non-invasiveness, the hydrogen breath test (HBT) has become a popular technology to aid in the diagnosis of many gastroenterological diseases, specifically lactose intolerance. Additionally, while administering the HBT there seems to be a lack of uniform criteria amongst the various studies, with many using their own guidelines, which may in turn cause inconsistency with the analysis of the results. With ever improving nanotechnology, novel approaches to expedite and lower the costs of the HBT has become an area of research with significant advancements.

scholarly journals Lactulose Hydrogen Breath Test Result Is Associated with Age and Gender

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Carolyn Newberry ◽  
Ann Tierney ◽  
Octavia Pickett-Blakely
Keyword(s):  
Breath Test ◽  
Bacterial Overgrowth ◽  
Gastrointestinal Diseases ◽  
Small Intestinal Bacterial Overgrowth ◽  
Cross Sectional Study ◽  
Hydrogen Breath Test ◽  
Cross Sectional ◽  
Lactulose Hydrogen Breath Test ◽  
Significant Difference ◽  
And Gender

Small intestinal bacterial overgrowth (SIBO) is associated with chronic gastrointestinal diseases and structural/functional abnormalities of the gastrointestinal tract. SIBO’s association with clinical characteristics is unclear. This study investigates the association between clinical factors and SIBO according to lactulose hydrogen breath test (LHBT) result.Methods. A cross-sectional study in a university-based gastroenterology practice was performed. Data was abstracted from the medical records of subjects undergoing LHBT from 6/1/2009 to 6/1/2013. Logistic regression analysis was performed to determine the association between predictor variables: age, sex, body mass index (BMI), and positive LHBT, the outcome of interest.Results. LHBT was performed in 791 subjects. Fifty-four percent had a positive LHBT. There was no statistically significant difference between the LHBT results according to age or BMI. In females, the likelihood of a positive LHBT increased with age (OR 1.02; 95% CI: 1.01–1.03). In males, the likelihood of a positive LHBT result decreased with age (OR 0.98; 95% CI: 0.97–1.00).Conclusion. There was an association between age, with respect to sex, and a positive LHBT. With increased age in females, the odds of a positive LHBT increased, while, in men, the odds of a positive LHBT decreased with age.

scholarly journals Lactose intolerance, detected by the hydrogen breath test, in infants and children with chronic diarrhoea

1977 ◽  
Vol 52 (10) ◽  
pp. 766-771 ◽  
Author(s):  
H. V. L. Maffei ◽  
G. Metz ◽  
V. Bampoe ◽  
M. Shiner ◽  
S. Herman ◽  
...  
Keyword(s):  
Breath Test ◽  
Lactose Intolerance ◽  
Infants And Children ◽  
Chronic Diarrhoea ◽  
Hydrogen Breath Test ◽  
In Infants And Children

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

Nutrients ◽  
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.

scholarly journals Lactose Intolerance Assessed by Analysis of Genetic Polymorphism, Breath Test and Symptoms in Patients with Inflammatory Bowel Disease

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1290
Author(s):  
Olga Maria Nardone ◽  
Francesco Manfellotto ◽  
Caterina D’Onofrio ◽  
Alba Rocco ◽  
Giovanni Annona ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Breath Test ◽  
Lactose Intolerance ◽  
Intermediate Phenotype ◽  
Control Group ◽  
Nucleotide Polymorphisms ◽  
Wild Type ◽  
Hydrogen Breath Test ◽  
Inflammatory Bowel

Many patients with inflammatory bowel disease (IBD) restrict dairy products to control their symptoms. The aim of the study was to investigate the prevalence of lactose intolerance assessed with hydrogen breath test (H-BT) in IBD patients in clinical remission compared to a sex, age and BMI matched control population. We further detected the prevalence of three single nucleotide polymorphisms of the lactase (LCT) gene: the lactase non persistence LCT-13910 CC (wildtype) and the intermediate phenotype LCT-22018 CT and LCT-13910 AG; finally, we assess the correlation between genotype and H-BT. A total of 54 IBD patients and 69 control who underwent clinical evaluation, H-BT and genetic test were enrolled. H-BT was positive in 64.8% IBD patients and 62.3% control (p = 0.3). The wild-type genotype was found in 85.2% IBD patients while CT-22018, AG-13910 and CT-22018/AG-13910 polymorphisms were found in 9.3%, 1.8% and 3.7%. In the control group, the wild-type genotype, CT-22018, AG-13910 and CT-22018/AG-13910 polymorphisms were found in 87%, 5.8%, 5.8% and 1.4% of cases, respectively. Therefore, the wild-type and polymorphisms’ prevalence did not differ between IBD population and control group (85.2% vs. 87%, p = 0.1) (14.8% vs. 13%, p = 0.7). The correlation between positive H-BT and genetic analysis showed that the wild-type genotype was associated with higher rate of lactose intolerance in the total population (OR 5.31, 95%CI 1.73–16.29, p = 0.003) and in the IBD (OR 7.61, 95%CI 1.36–42.7, p = 0.02). The prevalence of lactose intolerance in IBD patients did not differ from that of control. Despite suggestive symptoms, about 1/3 of IBD patients are not lactose intolerant, thus not needing “a priori” elimination diet. This may encourage a rationale and balanced dietary management in IBD.

scholarly journals Studies on absorption and metabolism of palatinose (isomaltulose) in rats

2010 ◽  
Vol 105 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Hidekazu Tonouchi ◽  
Taketo Yamaji ◽  
Masayuki Uchida ◽  
Megumi Koganei ◽  
Akina Sasayama ◽  
...  
Keyword(s):  
Breath Test ◽  
Area Under The Curve ◽  
Load Test ◽  
Value Of Time ◽  
Breath Tests ◽  
Significant Difference ◽  
Plasma Insulin Levels ◽  
Carbohydrate Load ◽  
Expired Air

We evaluated the absorption and metabolism of palatinose in rats by the carbohydrate load test and the 13C- and H2-breath tests. We compared the results of these tests with those of sucrose, since sucrose is an isomer of palatinose and generally known to be degraded and absorbed from the small intestine. In the carbohydrate load test, blood glucose and plasma insulin levels after oral administration of palatinose rose more gradually and reached a maximum that was lower than that after sucrose administration. In the 13C-breath test, rats were orally administrated [1-13C]sucrose or [1-13C]palatinose and housed in a chamber. The expired air in the chamber was collected, and the level of 13CO2 in the expired air was measured at appropriate intervals for 360 min. The value of time taken to reach the maximum concentration for expired 13CO2 from [1-13Cglucose] ([1-13Cglc]) and [1-13Cfructose] ([1-13Cfru]) palatinose was significantly longer than that from [1-13Cglc] and [1-13Cfru]sucrose, respectively. The value of area under the curve (AUC) for [1-13Cglc]palatinose was larger than that for [1-13Cglc]sucrose, but AUC for [1-13Cfru] showed no difference between palatinose and sucrose. In the H2-breath test, the concentration of H2 in the expired air was measured for 420 min. H2 was hardly detected with both palatinose and sucrose and no significant difference was observed between the two groups. These results suggest that palatinose is utilised in vivo at a rate equal to that of sucrose.

scholarly journals Hydrogen Breath Test for Diagnosis of Lactose Malabsorption: The Importance of Timing and the Number of Breath Samples

2006 ◽  
Vol 20 (4) ◽  
pp. 265-268 ◽  
Author(s):  
Mauro Di Camillo ◽  
Vanessa Marinaro ◽  
Fiorenza Argnani ◽  
Tiziana Foglietta ◽  
Piero Vernia
Keyword(s):  
Breath Test ◽  
Lactose Intolerance ◽  
False Negative ◽  
False Negative Rate ◽  
Significant Loss ◽  
Hydrogen Breath Test ◽  
Lactose Malabsorption ◽  
Abdominal Symptoms ◽  
Negative Rate ◽  
Sample Test

BACKGROUND: The hydrogen breath test (H2BT) 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 1112 patients (292 men, 820 women) with a positive 4 h, nine-sample H2BT 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% (1014 of 1112) patients and in 96.1% (1068 of 1112) 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 H2BT is time-and cost-sparing without significant loss of sensitivity for the diagnosis both of lactose malabsorption and lactose intolerance.

Investigation in gastrointestinal disease

2018 ◽  
Author(s):  
Satish Keshav ◽  
Alexandra Kent
Keyword(s):  
Breath Test ◽  
Gastrointestinal Disease ◽  
Therapeutic Endoscopy ◽  
Full Blood Count ◽  
X Rays ◽  
Hydrogen Breath Test ◽  
Endoscopic Retrograde ◽  
Breath Tests ◽  
Blood Tests ◽  
Hida Scan

This chapter discusses investigation in gastrointestinal (GI) disease, including blood tests (full blood count, haematinics, biochemistry, immunology, microbiology, stool investigations), radiology (abdominal plain X-rays, barium studies, ultrasound, CT, MRI), nuclear medicine (SeHCAT scan, HIDA scan, gastric emptying study), endoscopy (oesophagogastroduodenoscopy, lower GI endoscopy, endoscopic retrograde cholangiopancreatography, therapeutic endoscopy, capsule endoscopy), and breath tests (lactulose/glucose-hydrogen breath test, lactose/hydrogen breath test, urea breath test).

scholarly journals Hydrogen and Methane Breath Test in the Diagnosis of Lactose Intolerance

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3261
Author(s):  
Charlotte De Geyter ◽  
Kris Van de Maele ◽  
Bruno Hauser ◽  
Yvan Vandenplas
Keyword(s):  
Breath Test ◽  
Lactose Intolerance ◽  
Symptom Improvement ◽  
Breath Tests ◽  
Non Invasive ◽  
Almost All ◽  
Additional Value ◽  
H2 Breath Test ◽  
Test Result ◽  
Significant Symptom

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.

Sign in / Sign up

Export Citation Format

Share Document