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Lactose Breath Hydrogen Test

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181. Honey may have a laxative effect on normal subjects because of incomplete fructose absorption. (Abstract)

of a glucose and fructose mixture. The breath-hydrogen concentration was measured every 15 min for 6 h. Semiquantitative estimates of carbohydrate malabsorption were assessed with lactose as a nonabsorbable standard. Breath-hydrogen concentrations increased by 52 +/- 6, 30 +/- 4, 20 +/- 3, and 4 +/- 1 ppm (mean +/- SEM) after each of the four test solutions, respectively. The estimated carbohydrate malabsorption was 10.3 +/- 1.8, 5.9 +/- 1.2, and 0.5 +/- 0.2 g after 100 g honey, 50 g honey, and the glucose

1996 The American journal of clinical nutrition Controlled trial quality: uncertain

182. Distribution of adult lactase phenotypes in the Tuareg of Niger. (Full text)

Distribution of adult lactase phenotypes in the Tuareg of Niger. The adult lactase phenotype, lactose absorber or malabsorber, was determined using the lactose tolerance test with breath hydrogen assay in a group of Tuareg, a traditionally nomadic pastoralist population in the central Sahara. Out of a total of 118 subjects, 103 (87.3%) were lactose absorbers and 15 (12.7%) lactose malabsorbers. The frequency of the "lactase suppression gene" in this population sample was .357 (SD .043). The low

1986 American Journal of Human Genetics PubMed abstract

183. [Effects of neomycin on intestinal digestion, absorption and fermentation of carbohydrates in patients with liver cirrhosis: evidence for an alternative therapeutic mechanism in hepatic encephalopathy]. (Abstract)

malabsorption.To investigate the effects of neomycin on intestinal digestion, absorption and fermentation of carbohydrates in patients with liver cirrhosis.Thirty eight Child B or C cirrhotic patients separated in three groups; subjects within each group were randomized to receive neomycin (2/g/day for 10 days, n = 8) or placebo (n = 4). Absorption of lactose and d-xylose and fermentation of d-xylose, lactose and lactulose (measured using hydrogen breath tests) were studied before and after the treatment (...) period.Neomycin did not change lactose fermentation but reduced plasma glucose rise after lactose ingestion (38.8 +/- mg/dl to 22 +/- 6 mg/dl p < 0.05). Plasma d-xylose levels at 30 min and its 5 h urinary excretion were reduced by neomycin from 19 +/- 3 to 9 +/- 2 mg/dl and from 4.9 +/- 0, 8 to 2.6 +/- 0.3 g/5h respectively (p < 0.05). Fermentation of d-xylose, lactose and lactulose was not reduced by neomycin. No significant changes were observed after placebo treatment.Neomycin therapy is associated

1994 Revista médica de Chile Controlled trial quality: uncertain

184. [Clinical consequences of replacing milk with yogurt in persistent infantile diarrhea]. (Abstract)

hydrogen breath test results. Clinical treatment failure (weight loss greater than 5% in one day or persistent diarrhea after 5 days) was significantly less common in children fed yogurt (15 +/- 6%) than in children fed milk (45 +/- 8%). The beneficial effects of feeding yogurt were apparent within 48 hours in 67 +/- 8% of infants. In conclusion, these data confirm the clinical efficacy of substituting yogurt for milk in young children with persistent diarrhea. They also suggest that yogurt may (...) for milk, as the only treatment. After a one to two-day observation period during which a standard milk diet was given, 78 children aged 3 to 36 months with confirmed persistent diarrhea of more than 15 days but less than one month duration and negative tests for fecal blood were fed either milk (infant formula) or yogurt (infant formula fermented with Lactobacillus bulgaricus and Streptococcus thermophilus). At inclusion both groups were comparable for age, nutritional status, diarrhea, and lactose

1992 Annales de pédiatrie Controlled trial quality: uncertain

185. Fructose intolerance: an under-recognized problem. (Abstract)

Fructose intolerance: an under-recognized problem. Although the role of lactose intolerance in the pathogenesis of abdominal symptoms is well known, the role of fructose intolerance is unclear. Our aims were 1) to examine the prevalence of fructose intolerance in patients with unexplained abdominal symptoms, and 2) to explore whether fructose concentration influences fructose breath test.Over 2 yr, patients with unexplained symptoms answered questionnaires and underwent fructose breath tests (...) . Patients received 50 g fructose in 150 ml water (33% solution). Breath samples were collected for hydrogen and methane. In a second study, breath test was performed after giving either 10%, 20%, or 33% fructose solution. Data were analyzed retrospectively.A total of 183 patients (50 male, 133 female) had breath tests, of whom 134 (73%) were positive. Among these, 119 (89%) had elevated H(2), and 15 (11%) had elevated CH(4) or both gases. Questionnaires showed that flatus (83%), pain (80%), bloating (78

2003 American Journal of Gastroenterology

186. breath tests in gastroenterology

breath tests in gastroenterology breath tests in gastroenterology - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search breath tests in gastroenterology Breath tests may be used to assess: malabsorption of specific carbohydrates e.g. lactose hydrogen breath test small intestine bacterial overgrowth e.g. glucose, 14C-xylose and 14C-glycocholate hydrogen breath tests fat absorption e.g. 14C-triolein breath test Isotopes are best

2010 GP Notebook

187. hydrogen breath test

. The test is most commonly used to diagnose lactose intolerance but may be used to detect rarer conditions such as hyposucrasia, and glucose-galactose malabsorption. Patients should avoid high roughage foods the evening before the test in an attempt to achieve a low basal breath hydrogen. Following an overnight fast, brushing the teeth will help eliminate oral fermentation of the substrate during the test. A basal sample is taken. Fifty grams of substrate in 200 ml of water are then swallowed. End (...) hydrogen breath test hydrogen breath test - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search hydrogen breath test The breath hydrogen test may be used to diagnose the malabsorption of specific carbohydrates. Sugars malabsorbed in the small bowel are metabolised by colonic bacteria with the production of hydrogen. The hydrogen diffuses rapidly across the colonic mucosa into the blood and can be measured in the breath

2010 GP Notebook

188. lactose breath test

lactose breath test lactose breath test - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search lactose breath test The breath hydrogen test may be used to diagnose the malabsorption of specific carbohydrates. Sugars malabsorbed in the small bowel are metabolised by colonic bacteria with the production of hydrogen. The hydrogen diffuses rapidly across the colonic mucosa into the blood and can be measured in the breath. The test (...) is most commonly used to diagnose lactose intolerance but may be used to detect rarer conditions such as hyposucrasia, and glucose-galactose malabsorption. Patients should avoid high roughage foods the evening before the test in an attempt to achieve a low basal breath hydrogen. Following an overnight fast, brushing the teeth will help eliminate oral fermentation of the substrate during the test. A basal sample is taken. Fifty grams of substrate in 200 ml of water are then swallowed. End-expiratory

2010 GP Notebook

189. How do I diagnose and treat lactose-intolerance in adults?

secondary causes. Other TestsBreath hydrogen test o This is the diagnostic test of choice. o Subjects are administered lactose after an overnight fast, after which expired air samples are collected before and at 30-minute intervals for 3 hours to assess hydrogen gas concentrations. o A rise in breath hydrogen concentration greater than 20 parts per million over the baseline after lactose ingestion suggests lactase deficiency. • Dietary elimination: Resolution of symptoms with elimination of lactose (...) . Within this the authors discuss both workup and treatment, which we have reproduced below. Workup “Lab Studies Lactose tolerance test • Measure serial blood glucose levels after an oral lactose load. A fasting serum glucose level is obtained, after which 50 g of lactose is administered. Measure the serum glucose level at 0, 60, and 120 minutes. • The lactose tolerance test has a sensitivity of 75% and a specificity of 96%. • False-negative results occur in presence of diabetes and small bowel

2008 TRIP Answers

190. Genotyping of the lactase-phlorizin hydrolase -13910 polymorphism by LightCycler PCR and implications for the diagnosis of lactose intolerance. (Full text)

Genotyping of the lactase-phlorizin hydrolase -13910 polymorphism by LightCycler PCR and implications for the diagnosis of lactose intolerance. Hypolactasia and lactose intolerance are common conditions worldwide. Hypolactasia seems to be strongly correlated with genotype C/C of the genetic variant C-->T(-13910) upstream of the lactase phlorizin hydrolase (LPH) gene. We developed a rapid genotyping assay for LPH C-->T(-13910) and investigated the relationship of positive lactose breath hydrogen (...) test (LBHT) results suggesting lactose intolerance with LPH C-->T(-13910) genotype.Using automated DNA purification on the MagNA Pure LC and real-time PCR on the LightCycler, we examined samples from 220 individuals to estimate genotype frequencies; we then determined LPH C-->T(-13910) genotype in samples from 54 Caucasian patients with a positive LBHT result and symptoms of lactose intolerance.Genotyping of 220 individuals revealed frequencies of 21.4%, 41.8%, and 36.8% for genotypes C/C, C/T

2006 Clinical Chemistry PubMed abstract

191. Effect of post-prandial posture on orocecal transit time and digestion of milk lactose in humans. (Abstract)

Effect of post-prandial posture on orocecal transit time and digestion of milk lactose in humans. We examined the effect of post-prandial body posture on orocecal transit time and absorption of milk lactose using the breath hydrogen test. In this experiment, subjects ingested a cup of commercially available milk to which we had added a small amount of lactosucrose (an indigestible trisaccharide), and then they lay on their backs or sat on a chair for the first 4 hr (from 08:00 to 12:00). After (...) longer than that under the sitting condition. In addition, the amount of breath hydrogen excretion under the supine condition was significantly lower than under the sitting condition, indicating that the unabsorbed milk lactose moved into cecum under the supine condition is smaller than that under the sitting condition. These findings provide evidence that postprandial supine posture works more beneficially to digest and absorb milk lactose when compared to the sitting posture.

2004 Journal of physiological anthropology and applied human science Controlled trial quality: uncertain

192. Rifaximin in patients with lactose intolerance. (Abstract)

Rifaximin in patients with lactose intolerance. Abdominal symptoms linked to lactose malabsorption may be caused by metabolic activity of colonic bacteria. Rifaximin, a non-absorbable rifampycin derivative, is active against colonic bacteria, it may be useful in the treatment of lactose intolerance.The aim of this study has been to evaluate short-term rifaximin therapy in patients with lactose intolerance.Thirty-two patients with lactose intolerance diagnosed using the hydrogen lactose breath (...) test were studied. Fourteen patients received rifaximin 800 mg/day for 10 days, 13 patients followed a diet without milk for 40 days and 5 patients received a placebo for 10 days. Total breath H(2) excretion expressed as area under the curve, and the symptom score were evaluated in all patients at the start, and subsequently after 10 and 40 days.In the 14 patients who received rifaximin for 10 days, area under the curve at day 10 and day 40 was statistically significantly lower than the one

2005 Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver Controlled trial quality: uncertain

193. Review article: lactose intolerance in clinical practice - myths and realities. (Abstract)

of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms.In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction. (...) Review article: lactose intolerance in clinical practice - myths and realities. Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance.To review current clinical practice and identify published literature on the management of lactose intolerance.PubMed was searched using the terms lactose, lactase

2007 Alimentary Pharmacology & Therapeutics

194. Lactose intolerance in infants, children, and adolescents. (Full text)

Lactose intolerance in infants, children, and adolescents. The American Academy of Pediatrics Committee on Nutrition presents an updated review of lactose intolerance in infants, children, and adolescents. Differences between primary, secondary, congenital, and developmental lactase deficiency that may result in lactose intolerance are discussed. Children with suspected lactose intolerance can be assessed clinically by dietary lactose elimination or by tests including noninvasive hydrogen (...) breath testing or invasive intestinal biopsy determination of lactase (and other disaccharidase) concentrations. Treatment consists of use of lactase-treated dairy products or oral lactase supplementation, limitation of lactose-containing foods, or dairy elimination. The American Academy of Pediatrics supports use of dairy foods as an important source of calcium for bone mineral health and of other nutrients that facilitate growth in children and adolescents. If dairy products are eliminated, other

2006 Pediatrics PubMed abstract

195. Do probiotics reduce adult lactose intolerance? A systematic review. (Abstract)

Do probiotics reduce adult lactose intolerance? A systematic review. To assess the efficacy of oral probiotics in adults with lactose intolerance through a systematic review of its effects on symptoms and breath hydrogen tests, and whether adding probiotics to nonfermented dairy products decreases lactose intolerance at that meal.We searched randomized controlled trials published between 1966 and December 2002. Databases in the search strategy included Medline and AMED. We reviewed references (...) of clinical trials and contacted authors of major articles and manufacturers of probiotic commercial products. Quality assessment was based on the McMaster guides and was performed by 5 independent reviewers. Data extraction was performed by 2 reviewers.A master list of 90 articles was compiled. Ten articles met inclusion and exclusion criteria and were consistent with our clinical question. Of the 9 studies that measured breath hydrogen, 3 were positive, 3 were negative, and 3 had both positive

2005 Journal of Family Practice

196. Lactose Intolerance

a fast, and noting the rise in blood glucose, rather like a glucose tolerance test. A positive test is reproduction of symptoms and rise in serum glucose by <1.11 mmol/L, 60-120 minutes after ingestion. However, this rather higher dose than is presented in a normal meal has been criticised as representing an atypical situation. This has now been superseded by breath hydrogen tests. Breath hydrogen test - if carbohydrate is unabsorbed in the gut, it is fermented by bacteria in the large intestine (...) hydrogen during large bowel fermentation. Antibiotics may produce false negative results. For diagnosis of lactose intolerance, 0.5-1.0 g/kg to a maximum of 12-25 g of lactose is given and an increase greater than 20 ppm of hydrogen is diagnostic. Genetic tests are available but so far cannot cover all the genetic mutations that exist within different populations. If difficulty remains, a small intestinal mucosal biopsy can be obtained by endoscopy for direct assay of lactase activity as well

2008 Mentor

197. Is it worth investigating patients with apparent irritable bowel syndrome for lactose intolerance and if so what is the most practical way of doing so?

intolerance and if so what is the most practical way of doing so? eMedicine, an American online textbook, holds an article on irritable bowel syndrome(1). This states that a lactose tolerance test or hydrogen breath test should be directed by history. It also suggests that inconsistent symptoms should alert to the possibility of an organic pathology and lists lactose intolerance as a differential diagnosis. A 2001 study describes a cohort of 17 IBS subsequently identified as having lactose malabsorbtion (...) (2). The authors state that after 6 weeks on a lactose restricted diet symptoms were markedly improved in the lactose malabsorbtion-positive patients. They add that after 5 years, one patient was lost to follow up and 14 of the remaining 16 still had no complaints during the lactose restricted diet. Another 2001 study examined a low-lactose diet in 33 patient with a positive lactose hydrogen breath test (3). They report that only 39% of patients improved on the low lactose diet and the authors

2003 TRIP Answers

198. What tests are available for lactose intolerance?

causes. Breath hydrogen test This is the diagnostic test of choice. Subjects are administered lactose after an overnight fast, after which expired air samples are collected before and at 30-minute intervals for 3 hours to assess hydrogen gas concentrations. A rise in breath hydrogen concentration greater than 20 parts per million over the baseline after lactose ingestion suggests lactase deficiency. Dietary elimination : Resolution of symptoms with elimination of lactose-containing food products (...) on administering the breath hydrogen test: - “Patients should avoid high roughage foods the evening before the test in an attempt to achieve a low basal breath hydrogen. Following an overnight fast, brushing the teeth will help eliminate oral fermentation of the substrate during the test. - A basal sample is taken. Fifty grams of substrate in 200 ml of water are then swallowed. End-expiratory breath samples are recorded at 15 or 30 minute intervals for two hours. A positive test is indicated by a rise of 20

2005 TRIP Answers

199. Lack of relationship between lactose absorption and senile cataracts. (Abstract)

Lack of relationship between lactose absorption and senile cataracts. In a double-blind study using the hydrogen breath-excretion test to identify lactase status, we found 45% of absorbers in a group of 64 patients with senile cataracts compared with 71% of absorbers in the control group. These results oppose the hypothesis that lactose absorbers are especially prone to develop senile cataracts.

1989 Annals of Ophthalmology

200. Lactose absorption in patients with glucose 6-phosphate dehydrogenase deficiency with and without favism. (Full text)

in the past was characterised by an intermediate malarial endemicity.70 adult subjects with G6PD deficiency, 34 of whom had a past history of favism, and 50 age matched control subjects.The capacity to absorb lactose was assessed by measuring breath hydrogen production after oral administration of lactose (50 g) by a gas chromatographic method.Twenty per cent of G6PD deficient subjects with a positive history of favism and 22% of G6PD deficient subjects without a positive history of favism were lactose (...) Lactose absorption in patients with glucose 6-phosphate dehydrogenase deficiency with and without favism. It has recently been suggested that primary lactase deficiency might have been selected for by malaria, as has been previously shown to occur for thalasaemia and glucose 6-phosphate dehydrogenase (G6PD) deficiency.To test this hypothesis, the prevalence of primary lactase deficiency in G6PD deficient subjects and in controls from the area of Sassari (Northern Sardinia) was determined, which

1996 Gut PubMed abstract

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