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Lactose Breath Hydrogen Test

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141. Chronic and Recurrent Abdominal Pain

Sometimes regurgitation of gastric contents into mouth Barium swallow Endoscopy Chronic nonspecific pain Sometimes palpable RLQ mass Fever, diarrhea, weight loss Tuberculin test Endoscopy for biopsy CT with oral contrast Chest x-ray Bloating and cramps after ingesting milk products Hydrogen breath test Trial of elimination of lactose-containing foods Severe upper abdominal pain that Often radiates to the back Occurs late in disease, when weight loss is often present May cause obstructive jaundice CT (...) MRCP or ERCP Parasitic infestation (particularly ) History of travel or exposure Cramps, flatulence, diarrhea Stool examination for ova or parasites Stool enzyme immunoassay (for Giardia ) Upper abdominal pain relieved by food and antacids May awaken patient at night Endoscopy and biopsy for Helicobacter pylori H. pylori breath test Evaluation of NSAID use Stool examination for occult blood Postoperative adhesive bands Previous abdominal surgery Colicky discomfort accompanied by nausea

2013 Merck Manual (19th Edition)

142. Carbohydrate Intolerance

amounts may suggest another diagnosis. Diagnosis Clinical diagnosis Hydrogen breath test for confirmation Lactose intolerance can usually be diagnosed with a careful history supported by dietary challenge. Patients usually have a history of diarrhea and/or gas after ingestion of milk and dairy foods; other symptoms, such as rash, wheezing, or other anaphylactic symptoms (particularly in infants and children), suggest a cow's milk allergy . Milk allergy is rare in adults and also may cause vomiting (...) and symptoms of esophageal reflux, which are not manifestations of carbohydrate intolerance. The diagnosis is also suggested if the stool from chronic or intermittent diarrhea is acidic (pH < 6) and can be confirmed by an H 2 breath test or a lactose tolerance test. In the hydrogen breath test, 50 g of lactose is given orally and the hydrogen produced by bacterial metabolism of undigested lactose is measured with a breath meter at 2, 3, and 4 h postingestion. Most affected patients have an increase

2013 Merck Manual (19th Edition)

143. Overview of Malabsorption

carbohydrates in the colon, increasing exhaled hydrogen. The lactose-hydrogen breath test is useful only to confirm and is not used as an initial diagnostic test in the evaluation of malabsorption. The 14 C-xylose and hydrogen breath tests have replaced bacterial cultures of aspirates taken during endoscopy for diagnosis of . The Schilling test assesses malabsorption of vitamin B 12 . Its 4 stages determine whether the deficiency results from pernicious anemia, pancreatic exocrine insufficiency, bacterial (...) is suggestive but are not sensitive for mild pancreatic disease. The 14 C-xylose breath test helps diagnose bacterial overgrowth. 14 C-xylose is given orally, and the exhaled 14 CO 2 concentration is measured. Catabolism of ingested xylose by the overgrowth of flora causes 14 CO 2 to appear in exhaled breath. The hydrogen (H 2 ) breath test measures the exhaled hydrogen produced by the bacterial degradation of carbohydrates. In patients with disaccharidase deficiencies, enteric bacteria degrade nonabsorbed

2013 Merck Manual (19th Edition)

144. Diarrhea in Children

evaluation Sometimes hydrogen breath test Sometimes test for reducing substances in stool (to check for carbohydrates) and stool pH ( 6.0 indicates carbohydrates in stool) Cow's milk protein intolerance (milk protein allergy) Vomiting Diarrhea or constipation Hematochezia Anal fissures Failure to thrive Symptom resolution when cow's milk protein is eliminated Sometimes endoscopy or colonoscopy Excessive juice intake History of excessive juice or sugary drink intake (4–6 oz/day) Clinical evaluation (...) ) or reptiles ( Salmonella ) History of eating undercooked food ( Salmonella ) Recent ( 2 mo) antibiotic use ( C. difficile ) Day care center outbreak Stool culture Fecal leukocytes If patients appear ill, CBC, renal function tests, and blood culture If patient has recently been given antibiotics, stool testing for C. difficile toxin or food poisoning Allergy: Urticarial rash, lip swelling, abdominal pain, vomiting, diarrhea, difficulty breathing within minutes to several hours after eating Poisoning

2013 Merck Manual (19th Edition)

145. Effects of FODMAPs on Small Bowel Water Content: an MRI Study

- 315 minutes of ascending colon, colonic motility, symptoms questionnaires, small bowel transit time, breath hydrogen concentrations and tryptase faecal content. Previous work using mannitol and glucose indicates that mean (SD) SBWC at 40 minutes postprandial after ingesting 300ml glucose was 47 (SD 15) and using n=12 the investigators calculate the investigators can detect an increase of 20 ml in excess of this with 90% power which is very much less than the investigators are predicting (...) Intervention/treatment Phase Healthy Dietary Supplement: Glucose Dietary Supplement: Fructose Dietary Supplement: Fructan Dietary Supplement: Fructose and glucose Not Applicable Detailed Description: Title: Effects of FODMAPs (Fermentable Oligo-, Di-, and Mono-saccharides, And Polyols) on small bowel water content: an MRI study Background. FODMAPs consist of fructose, lactose, fructo- and galacto-oligosaccharides such as fructans and galactans, and polyols such as sorbitol and mannitol. These carbohydrates

2011 Clinical Trials

146. The Effect of Different Macronutrients on Ileal Brake Activation

day ] Gastric emptying by using the C13 stable isotope breath test [ Time Frame: 1 day ] Small bowel transit time by using lactulose hydrogen breath test [ Time Frame: 1 day ] Gallbladder volumes by gallbladder ultrasound [ Time Frame: 1 day ] Measurements in plasma and/or platelet poor plasma Plasma levels of the gut hormone Glucagon Like Peptide-1 (GLP-1) [ Time Frame: 1 day ] Measurements in plasma and/or platelet poor plasma Plasma levels of the gut hormone peptide YY (PYY) [ Time Frame: 1 day (...) (major interference with the execution of the experiment or potential influence on the study outcomes) will be decided by the principal investigator. Use of medication, including vitamin supplementation, except oral contraceptives, within 14 days prior to testing Administration of investigational drugs or participation in any scientific intervention study which may interfere with this study (to be decided by the principle investigator), in the 180 days prior to the study Major abdominal surgery

2011 Clinical Trials

147. Mild CFTR mutations and genetic predisposition to lactase persistence in cystic fibrosis. Full Text available with Trip Pro

, hydrogen-methane breath test (BT) with lactose loading was conducted and clinical symptoms typical for lactose malabsorption were assessed. The percentage of CF patients with C/C was similar to that observed in healthy subjects (HS) (31.5 vs 32.5% ). Eleven out of 52 (24.5%) CF C/C patients had abnormal BT results. The recalculated frequency of lactose malabsorption was similar for the entire CF and HS populations (6.9 vs 7.2%). Similarly as in the control group, few CF patients have identified (...) and linked to lactose consumption clinical symptoms. The frequency of LCT polymorphic variants in CF patients having and not having severe mutations of CFTR gene showed significant differences. The C allele was more frequent in homozygotes of the severe mutations than in patients carrying at least one mild/unknown mutation (P<0.0028) and in patients with at least one mild mutation (P < 0.0377). In conclusion, CF patients carrying mild CFTR mutations seem to have lower genetic predisposition to ATH

2011 European Journal of Human Genetics

148. Effect of age on fructose malabsorption in children presenting with gastrointestinal symptoms. (Abstract)

Effect of age on fructose malabsorption in children presenting with gastrointestinal symptoms. Fructose malabsorption can produce symptoms such as chronic diarrhoea and abdominal pain. Here, we retrospectively review breath hydrogen test (BHT) results to determine whether age has an effect on the clinical application of the fructose BHT and compare this with the lactose BHT.Patients were referred to a gastroenterology breath-testing clinic (2003-2008) to investigate carbohydrate malabsorption (...) as a cause of gastrointestinal symptoms. Patients received either 0.5 g/kg body weight of fructose (maximum of 10 g) or 2 g/kg of lactose (maximum of 20 g), in water, and were tested for 2.5 hours.Patient age showed a significant effect on the fructose BHT results (P < 0.001, 0.1-79 years old, n = 1093). The odds of testing positive for fructose malabsorption in paediatric patients (15 years old or younger, n = 760) decreased by a factor of 0.82/year (95% confidence interval 0.79-0.86, P < 0.001

2011 Journal of Pediatric Gastroenterology and Nutrition

149. Glutamine for the Treatment of Patients With Irritable Bowel Syndrome

ingestion for 2 weeks prior to inclusion into study and throughout the study duration Exclusion Criteria: current participation in another research protocol or unable to give informed consent women with a positive urine pregnancy test or breastfeeding history of inflammatory bowel disease, lactose intolerance, and/or celiac sprue + hydrogen breath test for bacterial overgrowth + antiendomysial antibody titer use of nonsteroidal antinflammatory drug(NSAIDs) 2 weeks before or during the study known (...) using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years to 72 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: men and women age 18-72 years old who developed post-infectious diarrhea-predominant IBS (D-IBS) increased intestinal permeability on Lactulose/Mannitol permeability test able and willing to cooperate with the study *absence of alcohol or NSAIDs

2011 Clinical Trials

150. Flatulence

activated charcoal (unknown oral dose) reduced hydrogen sulfide levels by 71%. In combination with yucca schidigera, and zinc acetate, this was increased to an 86% reduction in hydrogen sulfide, although flatus volume and number was unchanged. An early study reported activated charcoal (unknown oral dose) prevented a large increase in the number of flatus events and increased breath hydrogen concentrations that normally occur following a gas-producing meal. Garments & external devices In 1998, Chester (...) , in normal subjects, even very high rates of gas infusion into the small intestine (30 ml/min) are tolerated without complaints of pain or bloating and harmlessly passed as flatus per rectum. Secondly, studies aiming to quantify the total volume of gas produced by patients with irritable bowel syndrome (some including gas emitted from the mouth by eructation) have consistently failed to demonstrate increased volumes compared to healthy subjects. The proportion of hydrogen produced may be increased

2012 Wikipedia

151. Helicobacter pylori Full Text available with Trip Pro

, producing labelled that can be detected in the breath). It is not known which non-invasive test is more accurate for diagnosing a H. pylori infection, and the clinical significance of the levels obtained with these tests are not clear. Some drugs can affect H. pylori urease activity and give with the urea-based tests. An endoscopic biopsy is an invasive means to test for H. pylori infection. Low-level infections can be missed by biopsy, so multiple samples are recommended. The most accurate method (...) with a number of disorders of the . Testing for H. pylori is not routinely recommended. Testing is recommended if or low-grade gastric is present, after resection of early , for first-degree relatives with gastric cancer, and in certain cases of . Several methods of testing exist, including invasive and noninvasive testing methods. Noninvasive tests for H. pylori infection may be suitable and include tests, stool s, or the (in which the patient drinks —or -labelled , which the bacterium metabolizes

2012 Wikipedia

152. Irritable bowel syndrome

treatment has been ineffective. SIBO therapy [ ] Statistically significant reduction in IBS symptoms occurs following antibiotic therapy for . However, recent research has shown that the lactulose hydrogen breath test does not actually measure SIBO, and that SIBO is unlikely to be the cause of IBS. Psychological therapies [ ] There is low quality evidence from studies with poor methodological quality that psychological therapies can be effective in the treatment of IBS; however there are no significant (...) bowel disease, and malignancies) (to exclude fructose and lactose malabsorption) Misdiagnosis [ ] People with IBS are at increased risk of being given inappropriate surgeries such as , , and due to being misdiagnosed as other medical conditions. Some common examples of misdiagnosis include , coeliac disease, , (non- ). The American College of Gastroenterology recommends all people with symptoms of IBS be tested for coeliac disease. is also sometimes missed in people with diarrhea-predominant IBS

2012 Wikipedia

153. Biochemistry Full Text available with Trip Pro

carbohydrates are sugars. There are more carbohydrates on Earth than any other known type of biomolecule; they are used to store energy and , as well as play important roles in cell to and . The simplest type of carbohydrate is a , which among other properties contains carbon, hydrogen, and oxygen, mostly in a ratio of 1:2:1 (generalized formula C n H 2 n O n , where n is at least 3). (C 6 H 12 O 6 ) is one of the most important carbohydrates; others include (C 6 H 12 O 6 ), the sugar commonly associated (...) is released. The reverse reaction in which the glycosidic bond of a disaccharide is broken into two monosaccharides is termed . The best-known disaccharide is or ordinary , which consists of a molecule and a molecule joined together. Another important disaccharide is found in milk, consisting of a glucose molecule and a molecule. Lactose may be hydrolysed by , and deficiency in this enzyme results in . When a few (around three to six) monosaccharides are joined, it is called an ( oligo- meaning "few

2012 Wikipedia

154. Investigation of Alanine in Fructose Intolerance: A Dose Ranging Study

with unexplained GI symptoms is thought to be between 11-50%, when assessed with breath tests following administration of 25 grams of fructose in a 10% solution. Restriction of dietary fructose has been shown to improve symptoms in these patients to an extent. Currently, there are no therapeutic agents that improve intestinal fructose absorption and thereby decrease symptoms. Studies in the pediatric population have shown that fructose absorption in the small intestine is increased in the presence of glucose (...) or amino acids, especially alanine. Objective: The investigators' objective is to assess whether co-administration of an oral solution of L-alanine facilitates fructose absorption and decreases gastrointestinal (GI) symptoms associated with fructose malabsorption in subjects undergoing standard fructose breath test when compared to placebo. Methods and analysis: The investigators propose a randomized, double-blind study in 40 subjects with known fructose intolerance. After an overnight fast, each

2009 Clinical Trials

155. 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

156. 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

157. A comparison of diagnostic tests for lactose malabsorption--which one is the best? Full Text available with Trip Pro

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

2009 BMC Gastroenterology

158. Lack of effect of lactose digestion status on baseline fecal microflora Full Text available with Trip Pro

(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.

2009 Canadian Journal of Gastroenterology

159. Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders. (Abstract)

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

2009 Alimentary Pharmacology & Therapeutics

160. Irritable bowel syndrome in adults: diagnosis and management

(https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 7 of 22antibody testing for coeliac disease (endomysial antibodies [EMA] or tissue transglutaminase [TTG]). [2008] [2008] The following tests are not necessary to confirm diagnosis in people who meet the IBS diagnostic criteria: ultrasound rigid/flexible sigmoidoscopy colonoscopy; barium enema thyroid function test faecal ova and parasite test faecal occult blood hydrogen breath test (for lactose intolerance and bacterial (...) and management (CG61) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 11 of 221.1.2.2 The following tests are not necessary to confirm diagnosis in people who meet the IBS diagnostic criteria: ultrasound rigid/flexible sigmoidoscopy colonoscopy; barium enema thyroid function test faecal ova and parasite test faecal occult blood hydrogen breath test (for lactose intolerance and bacterial overgrowth). [2008] [2008] 1.2

2008 National Institute for Health and Clinical Excellence - Clinical Guidelines

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