MODIFICATION OF THE BREATH HYDROGEN TEST - INCREASED SENSITIVITY FOR THE DETECTION OF CARBOHYDRATE MALABSORPTION

  • 1 January 1982
    • journal article
    • research article
    • Vol. 100  (5) , 798-805
Abstract
The pulmonary excretion of H2 after a carbohydrate meal has been used to diagnose carbohydrate malabsorption in the small intestine. The protocol for performing breath tests has been modified by the addition of a prolonged carbohydrate-free preparation (> 15 h) and the adminstration of the test sugar in a defined formula containing protein and fat. The carbohydrate-free preparation significantly decreased baseline H2 excretion, implying that elevations in baseline H2 concentrations are related to carbohydrate malabsorption occurring on the night preceding the breath test. The excretion of H2 after carbohydrate meals was prolonged (> 8 h), with the majority of H2 excreted > 4 h after the meal. The time course of H2 excretion was similar in all subjects tested and was independent of the dose and type of sugar used. When H2 excretion between 4 and 7 h after the meal was analyzed, all subjects taking at least 3 g of lactulose excreted significant H2 as compared to those taking carbohydrate-free meals. The addition of 10 g of lactulose to the standard preparation on the night preceding a breath test caused a leftward shift in the time curve of H2 excretion after a subsequent 10 g lactulose meal, indicating earlier H2 production in the colon. Breath testing can apparently be used to determine the capacity for intestinal sugar absorption in human sand can probably demonstrate that prior sugar malabsorption may affect the breath H2 response to a meal.