Assessment of the reproducibility of the lactulose H2 breath test as a measure of mouth to caecum transit time.

Brooy, S J La; Malè, P.J.; Beavis, Adrian; Misiewicz, J. J.

doi:10.1136/gut.24.10.893

Cited by 145 publications

(53 citation statements)

References 11 publications

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“…/3-Lactulose acts quite differently when given in aqueous solution (La Brooy et al 1983) compared with a whole meal (Read et al 1980), and doesmot give a significant correlation with the gas formed after giving glucitol (Hyams, 1983) or Palatinit (present study). The discrepancy may be due to the method of administration, the competence of different bacterial strains (a-or P-glycosidic bonds respectively) and the absence of adaptation.…”

Section: Discussionmentioning

confidence: 52%

Dose dependence of breath hydrogen and methane in healthy volunteers after ingestion of a commercial disaccharide mixture, Palatinit®

1985

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1. Breath hydrogen and methane were determined by gas chromatography in eleven normal individuals given a low-fibre, mixed diet (control) and after ingestion of 20-50 g Palatinit@/d, an equimolar mixture of Dglucosyl-a( I + l)-D-mannitol and D-glUCOSyl-a( 1 + 6)-~-glucitol (Isomalt@).2. A linear relation was found (r 0.85; P < 0.001) between the amount of Palatinit ingested and breath H, per 10 h in subjects who did not exhale methane. If methane was formed in addition to H,, the sum of both gases followed a linear dose-effect relation.3. The mouth-to-caecum time, indicated by the first increase in breath H, after ingestion, was shortened by about half, yet no sign of diarrhoea was observed. Stool weight and stool frequency did not change significantly. The linear relation between a dose of 20-50 g Palatinit and exhalation of H, (eventually plus methane)indicated that a relatively constant fraction of the dose given underwent cleavage and absorption in the small intestine, the remainder being transported into the large bowel. Microbial gas formation in the colon as well as the fractional transfer of these gases into the expiratory air occurred at fixed proportions, thus allowing an insight into colonic microbial contributions to carbohydrate utilization in the human large bowel.

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Section: Discussionmentioning

confidence: 52%

Dose dependence of breath hydrogen and methane in healthy volunteers after ingestion of a commercial disaccharide mixture, Palatinit®

1985

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“…The onset of the rise was considerably delayed with the 5 g dose (171±41 min) but less so with the larger doses. This dose-related delay, which has also been observed in studies of breath hydrogen production (54,55), is a function of the rate of passage of lactulose through the small bowel, and in turn, can be explained by the differing osmolar loads of the various doses. In contrast to the rapid clearance of SCFA taken orally, blood acetate levels were high for 4-5 h after the first rise following lactulose in most subjects.…”

Section: Discussionmentioning

confidence: 77%

Carbohydrate fermentation in the human colon and its relation to acetate concentrations in venous blood.

Pomare¹,

Branch²,

Cummings³

1985

J. Clin. Invest.

283

118

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There is now substantial evidence that some dietary polysaccharides, notably dietary fiber, escape absorption in the small bowel and are then broken down in the large intestine of man. The main end products of this colonic digestive process, which is anerobic, are short chain fatty acids (SCFA), and acetic, propionic, and butyric acids. Although these acids are known to be absorbed from the colon, their subsequent fate and significance is unknown. We have measured venous blood SCFA levels in healthy subjects after a 16-h fast, and then following oral doses of either 50 mmol SCFA,5,10, or liter. Pectin fermentation was much slower, with blood acetate levels starting to rise after 6 h and remaining elevated at about twice fasting levels for the subsequent 18 h. However, areas under the blood acetate curves were closely related (r = 0.97; n = 5), whatever the source of acetate. These studies show that the large intestine makes an important contribution to blood acetate levels in man and that fermentation may influence metabolic processes well beyond the wall of this organ.

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“…Mean inter-individual COV (21 healthy subjects) was 18.5%, 30%, and 28% with doses of lactulose of 10, 15, and 20 g respectively. 48 Orocecal transit time with breath tests show variable correlation with barium radiography or scintigraphy. The correlation coefficients range from 0.31 to 0.95.…”

Section: Breath Testsmentioning

confidence: 99%

Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies

Rao¹,

Camilleri²,

Hasler³

et al. 2010

Neurogastroenterology &Amp; Motility

326

296

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Background Disorders of gastrointestinal (GI) transit and motility are common, and cause either delayed or accelerated transit through the stomach, small intestine or colon, and affect one or more regions. Assessment of regional and/or whole gut transit times can provide direct measurements and diagnostic information to explain the cause of symptoms, and plan therapy. Purpose Recently, several newer diagnostic tools have become available. The American and European Neurogastroenterology and Motility Societies undertook this review to provide guidelines on the indications and optimal methods for the use of transit measurements in clinical practice. This was based on evidence of validation including performance characteristics, clinical significance, and strengths of various techniques. The tests include measurements of: gastric emptying with scintigraphy, wireless motility capsule, and 13 C breath tests; small bowel transit with breath tests, scintigraphy, and wireless motility capsule; and colonic transit with radioopaque markers, wireless motility capsule, and scintigraphy. Based on the evidence, consensus recommendations are provided for each technique and for the evaluations of regional and whole gut transit. In summary, tests of gastrointestinal transit are available and useful in the evaluation of patients with symptoms suggestive of gastrointestinal dysmotility, since they can provide objective diagnosis and a rational approach to patient management.

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Assessment of the reproducibility of the lactulose H2 breath test as a measure of mouth to caecum transit time.

Cited by 145 publications

References 11 publications

Dose dependence of breath hydrogen and methane in healthy volunteers after ingestion of a commercial disaccharide mixture, Palatinit®

Dose dependence of breath hydrogen and methane in healthy volunteers after ingestion of a commercial disaccharide mixture, Palatinit®

Carbohydrate fermentation in the human colon and its relation to acetate concentrations in venous blood.

Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies

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