Breath Tests in Pediatric Gastrointestinal Disorders: New Diagnostic Opportunities

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Abstract
Among physiological materials available for sampling by the pediatrician, breath has received the least attention. Important questions concerning breath collection methods and the sensitivity and specificity of breath tests remain to be answered. Nevertheless, the validation and the use of nonradioactive labels and simpler collection methods have established the safety, noninvasiveness, and simplicity of breath tests for use in the pediatric population. Because samples can be collected in the field, office, or hospital and are easily stored, the use of central laboratory facilities will permit pooling of resources and decreased cost. In the case of hydrogen excretion following carbohydrate loads, accurate measurements within the diagnostic range of 2 to 10 ppm are possible by gas chromatographs equipped with thermal conductivity detectors, and should be available in most hospital laboratories. For the application of stable isotopically labeled substrates, the development of regional mass spectrometry centers will permit easier accessibility to and reduced cost of the requisite technology for isotope measurement. Thus, breath tests hold considerable promise for extending our capacity to study and evaluate in vivo metabolic processes both in the clinic and in the laboratory.