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Lactose Breath Hydrogen Test

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61. Effectiveness, Safety and Tolerability Study of RP-G28 for Symptoms Associated With Lactose Intolerance

or placebo Qualified subjects randomized to daily dosing with RP-G28 or placebo Drug: RP-G28 or placebo Daily dosing Outcome Measures Go to Primary Outcome Measures : 1) Change from Baseline in breath hydrogen production on Hydrogen Breath Test. 2) Change from Baseline in lactose intolerance symptom assessment during lactose challenge [ Time Frame: Baseline, 36 days ] Secondary Outcome Measures : Number of Subjects with Adverse Events as Measure of Safety and Tolerability [ Time Frame: 36 days ] Number (...) for Study: 18 Years to 64 Years (Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Male and female subjects. Female subjects must be non-pregnant and non-lactating. 18 to 64 years of age inclusive at Screening Current or recent history of intolerance to milk and other dairy products Acceptable Baseline Lactose Intolerance Symptom Scores Acceptable Result on Baseline Hydrogen Breath Test Subjects must agree to refrain from all other treatments and products

2010 Clinical Trials

62. Differential impact of lactose/lactase phenotype on colonic microflora (PubMed)

following lactose challenge tests, were measured.Lactose maldigesters had a mean change difference (0.72 log10 colony forming unitsg stool; P=0.04) in bifidobacteria counts compared with lactose digesters. Lactobacilli counts were increased, but not significantly. Nevertheless, reduced breath hydrogen after lactose ingestion correlated with lactobacilli (r=-0.5; P<0.001). Reduced total breath hydrogen and symptom scorestogether, with a rise in fecal enzymes after intervention, were appropriate (...) in ability to digest lactose is supported.A four-week study was performed in 23 lactose maldigesters and 18 digesters. Following two weeks of dairy food withdrawal, subjects ingested 25 g of lactose twice a day for two weeks. Stool bifidobacteria and lactobacilli counts pre- and postintervention were measured as the primary outcome. For secondary outcomes, total anaerobes, Enterobacteriaceae, beta-galactosidase and N-acetyl-beta-D-glucosaminidase activity in stool, as well as breath hydrogen and symptoms

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2010 Canadian Journal of Gastroenterology

63. Lactose intolerance in patients with chronic functional diarrhea: the role of small intestinal bacterial overgrowth. (PubMed)

controls underwent a validated 20 g lactose hydrogen breath test (HBT). Patients completed also a 10 g lactulose HBT with concurrent assessment of small bowel transit by scintigraphy.Lactose malabsorption was present in 27/31 (87%) patients with CFD and 29/32 (91%) healthy controls (P = 0.708). From the patient group 14/27 (52%) had lactose intolerance and 13/27 (48%) experienced no symptoms (lactose malabsorption controls). Only 5 (17%) healthy controls reported symptoms (P < 0.01). The oro-caecal (...) Lactose intolerance in patients with chronic functional diarrhea: the role of small intestinal bacterial overgrowth. Many studies report a high prevalence of lactose intolerance in patients with functional, gastrointestinal disease.To evaluate the role of small intestinal bacterial overgrowth (SIBO) in condition of lactose intolerance and the mechanism by which SIBO may impact lactose tolerance in affected patients.Consecutive out-patients with chronic functional diarrhoea (CFD) and healthy

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2010 Alimentary Pharmacology & Therapeutics

64. Comparison of efficacies between live and killed probiotics in children with lactose malabsorption. (PubMed)

Comparison of efficacies between live and killed probiotics in children with lactose malabsorption. The objective of this study was to determine the efficacy of live and killed probiotics to decrease the presence of hydrogen using the breath hydrogen test (BHT). This pretest-posttest control group design single blinded randomized study was performed in 5 government elementary schools in Tuminting subdistrict, Manado, Indonesia from March to May 2008. The study for inclusion as subjects (...) results before and 120 minutes after giving probiotic for the children taking both the live and the killed probiotic (p < 0.001). When the children taking the live and killed probiotics were compared, there was no difference in the BHT at 120 minutes of probiotic (p = 0.453) by t-test. The administration of live or killed probiotic for 2 weeks can decrease the results of a BHT in children with lactose malabsorption. No adverse reactions attributable to treatment were noted.

2010 The Southeast Asian journal of tropical medicine and public health Controlled trial quality: uncertain

65. The effect of oral supplementation with Lactobacillus reuteri or tilactase in lactose intolerant patients: randomized trial. (PubMed)

breath test (H,-LBT).Sixty lactose intolerant patients participated in the study and were randomized to three 20 patients-treatment groups: tilactase group (tilactase 15 minutes before control H2-LBT); placebo group (placebo 15 minutes before control H2-LBT); Lactobacillus reuteri group (LR) (LR b.i.d. during 10 days before control H2-LBT). The outcomes were LBT normalization rate, and influences of treatments on both mean maximum hydrogen concentration and clinical score.LBT normalization rate (...) The effect of oral supplementation with Lactobacillus reuteri or tilactase in lactose intolerant patients: randomized trial. Lactase enzyme supplements and probiotics with high beta-galactosidase activity may be valid treatment options for the lactose intolerance. Aim of this study was to assess whether supplementation with tilactase or Lactobacillus reuteri when compared to placebo affects hydrogen breath excretion and gastrointestinal symptoms in lactose intolerant patients during lactose

2010 European review for medical and pharmacological sciences Controlled trial quality: uncertain

66. Irritable bowel syndrome

infection family and job stress Diagnostic investigations FBC stool studies anti-endomysial antibodies anti-tTG antibodies plain abdominal x-ray flexible sigmoidoscopy colonoscopy hydrogen breath test faecal calprotectin serum CRP Treatment algorithm ONGOING Contributors Authors Chief of Gastroenterology and Hepatology Kelsey-Seybold Clinic Clinical Professor of Medicine Baylor College of Medicine Houston Adjunct Professor of Medicine University of Texas Medical Branch Galveston TX Disclosures NS (...) there are any dietary associations such as lactose-containing foods or fructose-containing foods. Examination of the abdomen is usually unremarkable. There may be mild and poorly localised tenderness in the right lower quadrant and/or left lower quadrant. The diagnosis is based on the patient's history, and there are no specific diagnostic tests. If the patient has worrying symptoms or findings such as anaemia, weight loss, or fever, then these require more thorough investigation. Treatment should

2019 BMJ Best Practice

67. Lactase deficiency

enteritis/gastroenteritis comorbid predisposing disease history of irritable bowel syndrome diagnosis Diagnostic investigations trial of dietary lactose elimination FBC lactose hydrogen breath test stool culture faecal pH faecal reducing substance/sugar lactose tolerance test small bowel biopsy genotyping 13C-labelled lactose breath test Treatment algorithm ACUTE Contributors Authors Academic Neuro-Gastroenterologist University College London Consultant Gastroenterologist University College Hospital (...) Lactase deficiency Lactase deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Lactase deficiency Last reviewed: February 2019 Last updated: November 2018 Summary Lactose intolerance is characterised by reduced lactase concentration in the mucosal brush border of the small intestine (also known as hypolactasia). It exists in four distinct forms: primary, secondary, congenital, and developmental. Symptoms can

2018 BMJ Best Practice

68. Irritable bowel syndrome

infection family and job stress Diagnostic investigations FBC stool studies anti-endomysial antibodies anti-tTG antibodies plain abdominal x-ray flexible sigmoidoscopy colonoscopy hydrogen breath test faecal calprotectin serum CRP Treatment algorithm ONGOING Contributors Authors Chief of Gastroenterology and Hepatology Kelsey-Seybold Clinic Clinical Professor of Medicine Baylor College of Medicine Houston Adjunct Professor of Medicine University of Texas Medical Branch Galveston TX Disclosures NS (...) there are any dietary associations such as lactose-containing foods or fructose-containing foods. Examination of the abdomen is usually unremarkable. There may be mild and poorly localised tenderness in the right lower quadrant and/or left lower quadrant. The diagnosis is based on the patient's history, and there are no specific diagnostic tests. If the patient has worrying symptoms or findings such as anaemia, weight loss, or fever, then these require more thorough investigation. Treatment should

2018 BMJ Best Practice

69. Management of Irritable Bowel Syndrome (IBS)

symptoms. GRADE: Strong recommendation, very low-quality evidence 8: We recommend AGAINST the routine use of lactose hydrogen breath tests in evaluating IBS patients. GRADE: Strong recommendation, very low-quality evidence 9: We recommend AGAINST the routine use of glucose hydrogen breath tests in evaluating IBS patients. GRADE: Strong recommendation, very low-quality evidence DIETARY MODIFICATIONS AND ALTERNATIVE THERAPIES FOR IBS 10: We suggest offering IBS patients a low FODMAP diet to reduce IBS (...) , 4.55?8.68) (Figure 2). There was no significant heterogeneity between studies. Figure 1. Proportion of subjects with lactose intolerance in IBS patients and healthy volunteers Statement 8: We recommend AGAINST the routine use of lactose hydrogen breath tests in evaluating IBS patients. GRADE: Strong recommendation, very low-quality evidence. Vote: strongly agree, 67%; agree, 25%; neutral, 8% Statement 9: We recommend AGAINST the routine use of glucose hydrogen breath tests in evaluating IBS

2019 Canadian Association of Gastroenterology

70. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

Description and Application of the Guidelines 5 Administrative Guidelines 6 Ordering of Multiple Studies 6 Simultaneous Ordering of Multiple Studies 6 Repeated Imaging 6 Pre-Test Requirements 7 History 7 Imaging of the Abdomen and Pelvis 8 General Information/Overview 8 Scope 8 Technology Considerations 8 Definitions 9 Clinical Indications 11 General Abdominal and Pelvic Indications 11 Congenital and developmental conditions 11 Infectious and inflammatory conditions – not otherwise referenced 11 Trauma 12 (...) preference or quality concerns ? Repeated imaging of the same anatomic area (MRI or CT) based on persistent symptoms with no clinical change, treatment, or intervention since the previous study Imaging of the Abdomen and Pelvis Copyright © 2019. AIM Specialty Health. All Rights Reserved. 7 ? Repeated imaging of the same anatomical area by different providers for the same member over a short period of time Pre-Test Requirements Critical to any finding of clinical appropriateness under the guidelines

2019 AIM Specialty Health

71. BSG consensus guidelines on the management of inflammatory bowel disease in adults

anastomosis; i.v.: intravenous; LFTs: liver function tests; MDT: multidisciplinary team; MeMP: methylmercaptopurine; MMR: measles mumps and rubella; MMX: Multi Matrix; MRE: magnetic resonance enterography; MRI: magnetic resonance imaging; NHS: national health service; NICE: Accepted manuscript 5 Version accepted by Gut 10 th June 2019 National Institute for Health and Care Excellence; NSAID: non-steroidal anti-inflammatory drug; OFG: orofacial granulomatosis; OR: odds ratio; PCR: polymerase chain reaction (...) Treatment of acute pouchitis 59 3.14.3 Treatment of chronic pouchitis 60 3.14.4 Treatment with biologics in chronic refractory pouchitis 61 3.14.5 Follow-up of pouch patients 61 3.14.6 Pouch surveillance 62 4 Crohn's disease 63 4.1 Diagnosis, classification and assessment 63 4.1.1 Phenotypic classification 63 4.1.2 Clinical and endoscopic disease activity 64 4.1.3 Diagnostic tests 66 Accepted manuscript 9 Version accepted by Gut 10 th June 2019 4.1.3.1 Cross-sectional imaging: CT, MR and small bowel

2019 British Society of Gastroenterology

72. Lactase deficiency

enteritis/gastroenteritis comorbid predisposing disease history of irritable bowel syndrome diagnosis Diagnostic investigations trial of dietary lactose elimination FBC lactose hydrogen breath test stool culture faecal pH faecal reducing substance/sugar lactose tolerance test small bowel biopsy genotyping 13C-labelled lactose breath test Treatment algorithm ACUTE Contributors Authors Academic Neuro-Gastroenterologist University College London Consultant Gastroenterologist University College Hospital (...) Lactase deficiency Lactase deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Lactase deficiency Last reviewed: February 2019 Last updated: November 2018 Summary Lactose intolerance is characterised by reduced lactase concentration in the mucosal brush border of the small intestine (also known as hypolactasia). It exists in four distinct forms: primary, secondary, congenital, and developmental. Symptoms can

2017 BMJ Best Practice

73. Validation of a Home-Screening Test for Lactose Intolerance

Information provided by: University Hospitals, Leicester Study Details Study Description Go to Brief Summary: The hypothesis underlying this study is that whilst there is no home-screening test for lactose intolerance, this test would have significant value as lactose tolerance tests and breath hydrogen tests are expensive and time consuming. Therefore, it would be highly beneficial to validate a simple home-screening test. This study will validate a simple home-screening test that uses lactose (...) Validation of a Home-Screening Test for Lactose Intolerance Validation of a Home-screening Test for Lactose Intolerance - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Validation of a Home-screening Test

2009 Clinical Trials

74. A comparison of diagnostic tests for lactose malabsorption--which one is the best? (PubMed)

A comparison of diagnostic tests for lactose malabsorption--which one is the best? Perceived milk intolerance is a common complaint, and tests for lactose malabsorption (LM) are unreliable. This study assesses the agreement between diagnostic tests for LM and describes the diagnostic properties of the tests.Patients above 18 years of age with suspected LM were included. After oral intake of 25 g lactose, a combined test with measurement of serum glucose (s-glucose) and hydrogen (H2) and methane (...) %) had LM. The agreement (kappa-values) between the methods varied from 0.25 to 0.91. The best test was the lactose breath test with measurement of the increase in H2 + CH4x2 in expired air. With a cut-off level < 18 ppm, the area under the ROC-curve was 0.967 and sensitivity was 100%. This shows that measurement of CH4 in addition to H2 improves the diagnostic properties of the breath test.The agreement between commonly used methods for the diagnosis of LM was unsatisfactory. A lactose breath test

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2009 BMC Gastroenterology

75. Guidelines for the investigation of chronic diarrhoea in adults

and left colon (not rectal) to exclude microscopic colitis (Grade of evidence level 1, Strength of recommendation strong). Malabsorption ? If lactose maldigestion is suspected, we suggest hydrogen breath testing (if available) or withdrawal of dietary lactose/ carbohydrates from the diet (Grade of evidence level 3, Strength of recommendation weak). ? MR enterography is recommended for evaluation of small bowel abnormalities depending on availability (Grade of evidence level 1, Strength (...) 100% in the Han Chinese population. 158 There is a high level of concordance between the presence of this genotype and lactose malabsorption. 156 In contrast, there is no unique genotype linked with fructose or fructan malabsorption and a review of nine studies found that 25 g fructose may induce an increase in breath hydrogen in 40% of healthy subjects, but rarely induces symptoms. 153 Prospective studies have shown that self-reported dietary intolerance is a poor predictor of objective test

2018 British Society of Gastroenterology

76. Diet and the Gut

can tolerate is critical in determining its implications for health [ ]. The presence of malabsorption of lactose is commonly not associated with symptoms. It is only when lactose malabsorption induces symptoms that “lactose intolerance” can be diagnosed. Lactose hydrogen breath testing. Lactose hydrogen breath testing is currently considered to be the most cost-effective, noninvasive, and reliable measure of lactose malabsorption [ ]. The breath test usually involves consumption of 25 g or 50 g (...) of lactose, followed by measurement of breath hydrogen and methane over the following 3–4 hours. Although diagnostic guidelines vary, an increase in breath hydrogen by 20 ppm (parts per million) above baseline or in methane by 10 ppm above baseline suggests lactose malabsorption [ ]. Lactose “tolerance” test [ ]. This is a blood test for lactase deficiency, and the traditional term “tolerance” test is a misnomer. The patient consumes 50 g of lactose dissolved in water. Samples of capillary blood

2018 World Gastroenterology Organisation

77. Validation of Breath Tests in Diagnosing Small Bowel Bacterial Overgrowth

no known hydrogen production occurs in mammalian tissue. The hydrogen breath test most often used in routine clinical practice uses glucose. However, the utility of this test is mostly limited by its low sensitivity, because there are "nonproducers" in up to 25% of the subjects tested. The investigators have developed a stable isotope breath test using 13C-labeled lactose-ureide. Glycosyl-ureides are condensation products of reducing sugars and urea in aqueous acid. Lactose-[13C]ureide has been used (...) to investigate oro-caecal transit time because it resists digestion by small intestinal enzymes and is hydrolyzed by bacterial enzymes in the large intestine. A number of studies have described the use of this substrate in adults and children. The aim of the present study was to investigate the lactose-[13C]ureide breath test in subjects with suspected SBBO and to compare its results with the results of the glucose hydrogen breath test. Microbiological analyses of upper intestinal bacterial cultures were

2009 Clinical Trials

78. 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

79. Low-FODMAP diets : irritable bowel syndrome (IBS)

diets and direct people to the Monash University webpages for additional information (see Consumer resources). Adherence to this diet may be difficult for approximately 30% of patients with an IBS that is potentially linked to FODMAPs. Conversely, convincing adherent patients who have not responded to stop the low-FODMAP diet can also be difficult. Assessing lactose absorption using hydrogen-breath-testing may help to distinguish those patients whose IBS is associated with lactose intolerance (...) . Hydrogen-breath testing, however, is not recommended for guiding clinical decisions relating to any other FODMAP. Grading NHMRC Level 2 evidence. References Halmos E, Power V, Shepherd S et al. . Gastroenterology 2014;146(1):67–75. DOI: 10.1053/j.gastro.2013.09.046. Staudacher HM, Irving PM, Lomer MCE et al. . Nat Rev Gastroenterol Hepatol 2014;11(4):256–66. DOI:10.1038/nrgastro.2013.259. Tuck CJ. Muir JG, Barret JS et al. . Expert Rev Gastroenterol Hepatol 2014;8(7):819–34. DOI: 10.1586

2014 Handbook of Non-Drug interventions (HANDI)

80. Dyspepsia - proven functional

four times a day. [ ; ; ] Specialist investigations and management Specialist investigations and management Specialist investigations may include: Barium swallow or meal. Gastric scintigraphy to help confirm delayed gastric emptying, for example in people with post-prandial distress-type symptoms. Hydrogen breath tests to detect small intestinal bacterial overgrowth or lactose/fructose intolerance. Specialist management may include: Specialist Helicobacter pylori eradication regimens (...) , and depression, and managing these appropriately. Reviewing and stopping any drugs which may be exacerbating symptoms, if possible and appropriate. Testing for Helicobacter pylori infection should be arranged if the person's status is not known or uncertain. Ideally a carbon-13 urea breath test or stool antigen test should be used — ensuring the person has not taken a proton pump inhibitor (PPI) in the past 2 weeks, or antibiotics in the past 4 weeks. First-line H. pylori eradication therapy should

2018 NICE Clinical Knowledge Summaries

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