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Lactose Breath Hydrogen Test

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81. 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

82. Carbon monoxide poisoning

of carboxyhaemoglobin does not disprove carbon monoxide poisoning unless the sample has been taken during or soon after exposure ended. Carbon monoxide exposure in the home has been associated with carboxyhaemoglobin concentrations as low as 2.5% in non-smokers and 5% in smokers. Lactose intolerant patients have raised hydrogen (H2) levels in their expired breath which can interfere with the reading. Basis for recommendation Basis for recommendation These recommendations are based on the Public Health England (PHE (...) problems (for example, anxiety, psychomotor dysfunction, loss of balance, changes in sleep, memory, vision, and smell). Personality changes. Management of carbon monoxide poisoning should include: Measuring exhaled carbon monoxide levels using a breath test. Taking a heparinised venous blood sample. Giving 100% oxygen using a tight fitting mask with an inflated seal until the person is asymptomatic and carboxyhaemoglobin levels are 3% or less in non-smokers, and 10% or less in smokers. Using a CO-pulse

2018 NICE Clinical Knowledge Summaries

83. Irritable Bowel Syndrome (IBS)

Gastroenterology Organization, 2015 WGO Global Guidelines IBS 4 • Hydrogen breath test for lactose intolerance and small-intestinal bacterial overgrowth (SIBO). Medium resource levels • History, physical examination, exclusion of alarm symptoms, consideration of psychological factors • FBC, ESR or CRP, stool studies, thyroid function • Sigmoidoscopy* Low resource levels • History, physical examination, exclusion of alarm symptoms, consideration of psychological factors • FBC, ESR, and stool examination * N.B (...) intolerance Main symptoms and/or findings: • Symptoms (bloating, flatulence, diarrhea) acutely related to consumption of milk and dairy products. • Although genetic testing can now detect lactase deficiency, this is not necessarily predictive of intolerance, which is best tested using the lactose hydrogen breath test. Indeed, a substantial proportion of individuals who lack lactase can tolerate oral lactose despite bacterial fermentation. In countries with a high prevalence of lactase deficiency

2015 World Gastroenterology Organisation

84. Dimethyl fumarate (Skilarence) - plaque psoriasis

of quantification LOCF Last observation carried forward LS mean Least square mean MAA Marketing Authorisation Application MTX Methotrexate MedDRA Medical Dictionary for Regulatory Activities MEF Monoethyl fumarate (synonym: ethyl hydrogen fumarate) MHRA Medicines & Healthcare Products Regulatory Agency MMF Monomethyl fumarate NF-?B Nuclear factor ‘kappa-light-chain-enhancer of activated B-cells’ PASI Psoriasis Area and Severity Index PBI Patient Benefit Index PBQ Patient Benefit Questionnaire PD (...) application. The applicant indicated that dimethyl fumarate was considered to be a known active substance. The application submitted is composed of administrative information, complete quality data, non- clinical and clinical data based on applicants’ own tests and studies and/or bibliographic literature substituting/supporting certain test(s) or study(ies). Information on Paediatric requirements Pursuant to Article 7 of Regulation (EC) No 1901/2006, the application included an EMA Decision P/0287/2015

2017 European Medicines Agency - EPARs

85. Lack of effect of lactose digestion status on baseline fecal microflora (PubMed)

(n=27) completed diet questionnaires, genetic and breath hydrogen testing, and quantitative stool analysis for species of bacteria. Log10 transformation of bacterial counts was compared with lactose intake in both groups using multiple regression analysis.There was a significant relationship between genetic and breath hydrogen tests. Daily lactose intake was marginally lower in lactose maldigesters (median [interquartile range] 12.2 g [31 g] versus 15 g [29.6 g], respectively (...) ). There was no relationship between lactose intake and breath hydrogen tests in either group. There were no differences in bacterial counts between the two groups, nor was there a relationship between bacterial counts and lactose intake in either group.The differential bacterial effects of lactose were not quantitatively detected in stool samples taken in the present study.

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2009 Canadian Journal of Gastroenterology

86. Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders. (PubMed)

Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders. Fructose malabsorption, lactose malabsorption and an early rise in breath hydrogen after lactulose (ERBHAL) may play roles in induction of symptoms in gastrointestinal conditions.To compare prevalence and interactions of fructose malabsorption, lactose malabsorption and ERBHAL among healthy subjects and those with chronic intestinal disorders using consistent breath hydrogen testing (...) methodologies.Consecutive series of Caucasian patients with Crohn's disease (n = 91), ulcerative colitis (56), functional gastrointestinal disorders (FGID) (201), coeliac disease (136) and 71 healthy volunteers underwent breath hydrogen testing using lactulose, fructose and lactose.Early rise in breath hydrogen after lactulose occurred more commonly in healthy controls (39%) than in Crohn's disease (20%) and untreated coeliac disease (14%; P < 0.008), but not FGID (27%), ulcerative colitis (26%) or treated coeliac

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2009 Alimentary Pharmacology & Therapeutics

87. Slowly Digestible Carbohydrates and the Ileal Brake

feelings of hunger and stronger feelings of fullness indicate better outcomes. Breath hydrogen (fermentability) [ Time Frame: Acute study; 4 hours of measurement after consumption of test food ] Breath samples were collected in 15-minute intervals for 4 hours after consumption of test food and analyzed for hydrogen levels using a breath analyzer. Breath hydrogen levels are indicative of a food's fermentability. Eligibility Criteria Go to Information from the National Library of Medicine Choosing (...) response were measured using a 13C-labeled octanoic acid breath test and continuous glucose monitors, respectively. Glucose readings were continuously monitored 24 h prior to and 48 h after test meal consumption, and breath samples were collected for a 4 h period following test meal consumption. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 20 participants Allocation: Randomized Intervention Model: Crossover Assignment Masking

2018 Clinical Trials

88. Dietary Fibers and Satiety in Bariatric Patients

(SCFA), breath hydrogen (as a marker of large intestinal fermentation), the secretion of gastrointestinal (GI) satiation hormones and glycaemia in morbidly obese patients before and 6 month after RYGB surgery. The primary study outcome measure is macronutrient and food intake (grams and kcal eaten) at the ad libitum buffet meal as well as time to complete the meal. Secondary outcome measures are 1) Appetite ratings (validated visual analogue scales, VAS) including hunger, fullness, thirst, desire (...) to eat, and amount of food desired to eat. 2) Plasma concentrations of SCFA (propionate, acetate, butyrate). 3) Breath hydrogen (as a marker of large intestinal fermentation) 4) Plasma concentrations of gastrointestinal hormones (ghrelin, cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), peptide YY (PYY) and potentially other, yet to be identified gut hormones). 4) Concentrations of plasma insulin and glucagon and blood glucose. Randomized, single-blinded cross-over trial in 24 morbidly obese

2018 Clinical Trials

89. Effect of Genetic Variation in Starch-digesting Enzymes on Digestibility and Glycemic Index of Cold and Hot Rice

of breath hydrogen concentrations from the lowest value over 0-3 hours to 6 hours (termed "H"). For each subject the amount of hydrogen per gram malabsorbed carbohydrate (H/g) is calculated as (GL-G)/10 where GL is H after the glucose plus lactose meal and G is H after the glucose meal. The amount of carbohydrate malabsorbed after the hot and cold rice meals, respectively, are HR/Hg and CR/Hg, where HR and Cr are H after the hot and cold rice meals. Glycemic response [ Time Frame: 0-2 hours (...) ] The incremental area under the blood glucose response curve Breath hydrogen response [ Time Frame: 0-6 hours ] Sum of breath hydrogen concentrations from the lowest in the first 3 hours to 6 hours. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research

2018 Clinical Trials

90. Comparing the Digestion of Milk With Different Beta-casein Protein Content by Dairy Intolerant Persons

intolerance (e.g., Lactaid® Dietary Supplements) during study involvement Willing to return for all study visits and complete all study related procedures, including fasting before and during the hydrogen breath tests Qualifying Lactose Challenge Symptom Score: (4 symptom categories with severity measured on from 0 to 5) as defined by one of the following: At least one score of "moderately severe" or "severe" on a single symptom during the 6 hour HBT test; A score of "moderate" or greater for a single (...) symptom on at least two (2) time points during the 6 hour HBT test; At least one "moderate" score or greater on each of two symptoms during the 6 hour HBT test 7. Hydrogen concentration of at least 20 parts per million greater than baseline at least 2 time points during the screening hydrogren breath test 8. Able to understand and provide written informed consent in English Exclusion Criteria: Allergic to milk Currently pregnant Currently lactating Cigarette smoking or other use of tobacco or nicotine

2018 Clinical Trials

91. Rapid Orocecal Transit Time and Fermentation in IBS.

: Lactulose breath test Lactulose 0.67 mg/mL, dose 15 mL (10 grams). No contaminants of lactose. Pharmacy quality. Outcome Measures Go to Primary Outcome Measures : Orocecal transit time [ Time Frame: 0-240 minutes ] The transit rate of lactulose (foods) through the small intestine Secondary Outcome Measures : Fermentation of lactulose of the cecal microbiota measured as increase of hydrogen in exhaled breath. [ Time Frame: 0-240 minutes ] The rise of hydrogen (beyond 10 and 20 ppm) after lactulose (...) by (Responsible Party): Per Hellström, Uppsala University Study Details Study Description Go to Brief Summary: Orocecal transit time is studied in individuals with irritable bowel syndrome (IBS) of both the constipation-dominant, diarrhea-dominant, and mixed form using the lactulose hydrogen breath test for orocecal transit time through the gut. Data are compared to those of healthy volunteers. The peak value of fermentation as read by hydrogen levels is captured after passage of the orocecal segment

2017 Clinical Trials

92. β-thalassemia minor, carbohydrate malabsorption and histamine intolerance (PubMed)

with β-thalassemia minor suffering nonspecific abdominal symptoms due to a carbohydrate and histamine malabsorption. Design/methods: The diagnosis of β-thalassemia minorwas done with peripheral blood smear and cellulose acetate electrophoresis. Carbohydrate malabsorption was diagnosed with hydrogen breath tests and, histamine intolerance (HIT) with a serum diamine oxidase value <10 U/ml and more than two gastrointestinal symptoms described for HIT. Conclusion: The symptoms of gastrointestinal (...) β-thalassemia minor, carbohydrate malabsorption and histamine intolerance Background: β-thalassemia minor is characterized by reduced β-haemoglobin chain synthesis and sometimes mild anaemia, although carriers of β-thalassemia minorare usually clinically asymptomatic.Nonspecific abdominal complaints may be caused by gastrointestinal carbohydrate malabsorption (lactose and fructose) and/or malabsorption of biogenic amines (histamine), or proteins (gluten). Objectives: We report on two patients

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2017 Journal of community hospital internal medicine perspectives

93. Palbociclib (Ibrance) - locally advanced or metastatic breast cancer

sunlight. Samples were tested for assay and impurities. Degradation was only observed in the hydrogen peroxide and AAPH studies. No significant degradation was observed for acidic or basic conditions. In the solid state, no significant degradation was observed under elevated temperatures or light exposure. The assay and purity method for palbociclib drug substance was shown to be specific, selective and stability-indicating. The stability results indicate that the active substance manufactured (...) information, complete quality data, non-clinical and clinical data based on applicants’ own tests and studies and/or bibliographic literature substituting/supporting certain tests or studies. Information on Paediatric requirements Pursuant to Article 7 of Regulation (EC) No 1901/2006, the application included an EMA Decision CW/0001/2015 on the granting of a class waiver. Information relating to orphan market exclusivity Similarity Pursuant to Article 8 of Regulation (EC) No. 141/2000 and Article 3

2016 European Medicines Agency - EPARs

94. Coping with Common GI Symptoms in the Community: A Global Perspective on Heartburn, Constipation, Bloating, and Abdominal Pain/Discomfort

of esophageal acid exposure and assessment of the temporal association between heartburn symptoms and acidic reflux episodes • Manometry o Esophageal motility study, high-resolution manometry o Anorectal manometry • Imaging o Gastrointestinal barium series—air contrast swallow, meal and follow- through, enteroclysis o Double-contrast barium enema o Abdominal ultrasonography o Abdominal computed tomography (CT), magnetic resonance imaging (MRI) of the abdomen • Miscellaneous o Breath tests: lactose, glucose (...) , fructose [32] o Dietary exclusion, followed by challenge with specific dietary components, may be considered a diagnostic test o Therapeutic trial of acid suppression (the “proton-pump inhibitor test”) in patients with heartburn or other symptoms that might be related to acid reflux o Food allergy or intolerance, lactose intolerance, eosinophilic infiltrates 3 Heartburn It should be noted that not all common GI symptoms are functional. This concept is particularly relevant for the symptom of heartburn

2013 World Gastroenterology Organisation

95. Gastro-oesophageal reflux in children - what's the worry?

based on the clinical assessment of the patient as differential diagnosis can vary significantly with different age groups. Noninvasive test for lactose intolerance (malabsorption) using lactose hydrogen breath test can be ordered, however, accessibility can be difficult. Stool reducing substances are unreliable and nonspecific for lactose intolerance and therefore are no longer recommended. Food specific serum IgE antibody (cap-FEIA testing) always requires clinical history for the appropriate (...) from endoscopic biopsies showed a mixture of neutrophils and mild eosinophilia in the lower oesophagus and duodenum. Oesophageal eosinophilia was less than 15 per high power field with no basal cell proliferation, ruling out eosinophilic oesophagitis. The other biopsies were unremarkable with normal small intestinal disaccharidases, ruling out lactose intolerance. These findings were consistent with GORD. Due to the timing of symptom development, the possibility of cow’s milk protein allergy

2012 Clinical Practice Guidelines Portal

96. Malabsorption, Orocecal Transit Time and Small Intestinal Bacterial Overgrowth in Type 2 Diabetic Patients: A Connection (PubMed)

, and most fluids are absorbed in small intestine. Malabsorption may occurs when proper absorption of nutrients does not take place due to bacterial overgrowth or altered gut motility. The present study was planned to measure various malabsorption parameters in type 2 diabetic patients. 175 patients and 175 age and sex matched healthy controls attending Endocrinology Clinic in PGI, Chandigarh were enrolled. Lactose intolerance was measured by using non-invasive lactose hydrogen breath test. Urinary d (...) -xylose and fecal fat were estimated using standard methods. Orocecal transit time and small intestinal bacterial overgrowth were measured using non-invasive lactulose and glucose breath test respectively. Out of 175 diabetic patients enrolled, 87 were males while among 175 healthy subjects 88 were males. SIBO was observed in 14.8 % type 2 diabetic patients and in 2.8 % of controls. There was statistically significant increase (p < 0.002) in OCTT in type 2 diabetic patients compared with controls

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2016 Indian Journal of Clinical Biochemistry

97. An Exploratory Study on the Effects of Repeat Doses of Albiglutide Compared to Exenatide on Gastric Myoelectrical Activity and Gastric Emptying in Type 2 Diabetes Mellitus Subjects

of nausea. The intensity of upper gastrointestinal symptom of nausea was measured using VAS ranging from 0 (no nausea) to 100 (severe nausea) immediately before (pre-WL) and 10, 20, 30 minutes post-WL. Individual Par. responses to VAS score scale has been presented. Part A: Time to Half-gastric Emptying [ Time Frame: Up to Day 5 ] Breath samples were collected to assess the time to half gastric emptying using gastric emptying breath test (GEBT) containing 13 Carbon (13C)-Spirulina pre-meal and post GEBT (...) emptying. This analysis was planned but not performed for Part B as the study was terminated during Part A. Part B: Rate of [13]C Dose Excreted in Breath [ Time Frame: Up to 8 weeks ] The rate of [13]C dose excreted in breath was assessed to study gastric empting using GEBT. This analysis was planned but not performed for Part B as the study was terminated during Part A. Part B: The Volume of Water Ingested During EGG [ Time Frame: Up to 8 weeks ] EGG with WLT is a standardized test to induce gastric

2016 Clinical Trials

98. Effect of Oat Bran on Bowel Function and Appetite

chromatography Fecal total bile acids [ Time Frame: 2 weeks and 4 weeks ] Fecal enzymes [ Time Frame: 2 weeks and 4 weeks ] fecal beta-glucoronidase Fecal ammonia [ Time Frame: 2 weeks and 4 weeks ] Intestinal gas production [ Time Frame: 2 weeks and 4 weeks ] using breath hydrogen production Appetite [ Time Frame: 2 weeks and 4 weeks ] Appetite will be measured via visual analogue score (VAS) Ad libitum energy intake [ Time Frame: 2 weeks and 4 weeks ] Ad libitum energy intake is measured by serving (...) Not Applicable Detailed Description: The study is a randomized, double-blind, placebo-controlled crossover study it involves a total of 8 visits with a 14 day run-in period for total study duration of 84 days. A washout period of 2 weeks will occur in between the 2, 28 day treatment periods. The effects of an oat bran beverage for breakfast on bowel function will be tested after 2 week and 4 weeks of intake. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial

2016 Clinical Trials

99. Flatulence

, Burping) No testing is typically needed, as this is nearly always aerophagia Gastric Bloating (symptoms begin <30 minutes after eating) Upper endoscopy Gastric Emptying Study Bloating (symptoms begin >30 minutes after eating) : IgA Tissue Transglutaminase (TTG) and Total IgA (if low, obtain IgG Gliadin instead of TTG) Hydrogen Breath Test Bloating with Rectal Exam (impaction, pelvic floor dysfunction) (TSH) Colon transit study Anorectal manometry XI. Management ral Avoid discounting patient concerns (...) fruit, honey, fruit juice, high fructose corn syrup) Fructans (fructo-oligosaccharides, inulins, levans - e.g. high fiber bars, onions, leeks, zucchini) Disaccharides (Lactose): Dairy, cheese, milk Polyols: cots, peaches Sugar s (esp. common in sugar-free gum): , xylitol, mannitol, malitol) Galactooligosaccharides or Raffinose (brussel sprouts, cabbage, green beans, lentils, legumes, chick peas) VI. Exam ral examination Focused abdominal exam Rectal exam VII. Findings: Red Flag Symptoms and signs

2018 FP Notebook

100. Lactase Deficiency

eating foods with lactose in them, you may feel sick to your stomach. You may also have Gas Diarrhea Swelling in your stomach Your doctor may do a blood, breath or stool test to find out if your problems are due to lactose intolerance. Lactose intolerance is not serious. Eating less food with lactose, or using pills or drops to help you digest lactose usually helps. You may need to take a calcium supplement if you don't get enough of it from your diet, since milk and foods made with milk are the most (...) ) Bloating or gas Cramping Foul smelling stools Large dairy intake or severe intolerance More significant symptoms of those listed above VI. Signs No weight loss associated with malabsorption VII. Differential Diagnosis (See secondary causes above) sis VIII. Evaluation Consider empiric trial off dairy products Also Consider (replaced by hydrogen test) IX. Management See Do not completely eliminate dairy products Risk of Lactase enzyme replacement (e.g. Lactaid, Dairy Ease) X. References Melrad in Goldman

2018 FP Notebook

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