Comparison of an increased waist circumference with a positive hydrogen breath test as a clinical predictor of lactose intolerance

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.

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

Canadian Journal of Gastroenterology ◽

10.1155/2006/715459 ◽

2006 ◽

Vol 20 (4) ◽

pp. 265-268 ◽

Cited By ~ 15

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.

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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.

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Hydrogen breath test for the diagnosis of lactose intolerance, is the routine sugar load the best one?

World Journal of Gastroenterology ◽

10.3748/wjg.14.6204 ◽

2008 ◽

Vol 14 (40) ◽

pp. 6204 ◽

Cited By ~ 14

Author(s):

Fiorenza Argnani ◽

Mauro Di Camillo ◽

Vanessa Marinaro ◽

Tiziana Foglietta ◽

Veronica Avallone ◽

...

Keyword(s):

Breath Test ◽

Lactose Intolerance ◽

Hydrogen Breath Test

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Short-Term Dairy Elimination and Reintroduction Minimally Perturbs the Gut Microbiota in Self-Reported Lactose Intolerant Adults

10.1101/2021.10.10.463842 ◽

2021 ◽

Author(s):

Courtney Jean Smith ◽

Les Dethlefsen ◽

Christopher Gardner ◽

Linda Nguyen ◽

Marcus Feldman ◽

...

Keyword(s):

Gut Microbiota ◽

Breath Test ◽

Dietary Intervention ◽

Lactose Intolerance ◽

Clinical Status ◽

Major Change ◽

Amplicon Sequencing ◽

Phenotypic Traits ◽

Hydrogen Breath Test ◽

16S Rrna Amplicon Sequencing

One of the outstanding questions regarding the human gut microbiota is how interventions designed to manipulate the microbiota may influence host phenotypic traits. Here, we employed a dietary intervention to probe this question in the context of lactose intolerance. To assess the effects of dairy elimination and reintroduction on the microbiota and host phenotype, we paired fecal 16S rRNA amplicon sequencing with a clinical assay for lactose intolerance, the hydrogen breath test. We studied 12 self-reported mildly lactose intolerant adults, each with tri-weekly collection of fecal samples over a 12-week study period (2 weeks baseline, 4 weeks of dairy elimination, 6 weeks of gradual milk reintroduction) and a hydrogen breath test before and after each phase. We found that although none of the subjects experienced a change in clinically defined status of lactose intolerant or tolerant, most subjects were qualitatively better able to tolerate dairy products with minimal symptoms at the end of the study compared to their baseline. Like clinical status, gut microbiota also resisted modification. Although the mean fraction of the genus Bifidobacterium, a group known to metabolize lactose, increased slightly with dairy reintroduction (from 0.0125 to 0.0206; Wilcoxon P = 0.068), the overall structure of each subject's gut microbiota remained highly individualized and largely stable. Our study is small, but it suggests the possibility of qualitatively improved tolerance in the absence of change in clinically defined tolerance nor major change in the gut microbiota.

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Clinical implication of the Hydrogen Breath Test for diagnosis of lactose intolerance and overgrows syndrome in infants

Pediatrician (St Petersburg) ◽

10.17816/ped419-15 ◽

2013 ◽

Vol 4 (1) ◽

pp. 9-15

Author(s):

Yelena Aleksandrovna Korniyenko ◽

Saida Sultanovna Kubalova ◽

Marina Aleksandrovna Dmitriyenko ◽

Igor Eduardovich Dzhagatspanyan

Keyword(s):

Real Time Pcr ◽

Breath Test ◽

Lactose Intolerance ◽

Functional Gastrointestinal Disorders ◽

Diagnostic Value ◽

Fecal Calprotectin ◽

Fecal Microbiota ◽

Gastrointestinal Disorders ◽

Hydrogen Breath Test ◽

Calprotectin Level

The aim of this study was to estimate the diagnostic value of the Hydrogen Breath Test (HBT) in diagnosis of lactose intolerance (LI) and overgrows syndrome (OS) in infants with functional gastrointestinal disorders (FGD). 102 infants from 1 to 6 months with FGD symptoms were investigated by HBT with lactose, fecal microbiota were examined by culture and real time PCR, fecal calprotectin was measured. LI was found in 37 % FGD infants, OS in 60 %. Calprotectin level was 445 ± 28 mg/g in OS and 195 ± 27 mg/g in infants without OS. Microbiota was altered in all FGD infants with increase of Cl. difficile, St. aureus. Infants with LI got Lactase Baby, infants with OS-L. reuteri in infant formula NAN Comfort or in drops Rela Life. Both were effective in elimination of FGD symptoms. Calprotectin level and microbiota disturbances were better after treatment.

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