Breath Hydrogen as a Diagnostic Method for Hypolactasia

“…because they can be influenced by many factors (3,5,6,8 ), as is well documented for the breath hydrogen test (1, 6, 10 -13 ); and (b) the abdominal discomfort produced in intolerant patients by the unphysiologically high doses of lactose [usually 50 (5)(6)(7)(8)(9)(10) or 25 g (11, 12 )]. In some cases, highly sophisticated equipment is required (10 -12 ).…”

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confidence: 99%

Noninvasive Evaluation of Intestinal Lactase with 4-Galactosylxylose: Comparison with 3- and 2-Galactosylxylose and Optimization of the Method in Rats

et al. 2006

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Background: Urinary excretion of D-xylose by suckling rats after ingestion of a mixture of 4-, 3-, and 2-galactosylxyloses reflects lactase activity in vivo. We aimed to select the most convenient of these disaccharides for detecting changes of the enzyme activity in vivo and to optimize the method. Methods: 4-, 3-, and 2-Galactosylxyloses were synthesized and purified, then orally administered to suckling rats of different ages. D-Xylose was measured colorimetrically by the phloroglucinol reaction in urine and plasma. Lactase activity was determined in extracts of small intestine mucosa with lactose, galactosylxyloses, and phlorizin as substrates. Results: D-Xylose appeared in the urine in a dosedependent manner after ingestion of any of the 3 galactosylxylose disaccharides. Correlation between D-xylose elimination and intestinal lactase activity was highest with 4-galactosylxylose (r ‫؍‬ 0.97; n ‫؍‬ 24), lower with 2-galactosylxylose (r ‫؍‬ 0.89; n ‫؍‬ 24), and lowest with 3-galactosylxylose (r ‫؍‬ 0.34; n ‫؍‬ 23). The kinetic properties of intestinal lactase accounted for these differences. D-Xylose concentration in plasma after administration of 4-galactosylxylose also correlated with lactase activity (r ‫؍‬ 0.93; n ‫؍‬ 33).

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“…Wolever & Robb (1992), examining the H 2 and CH 4 responses after ingestion of 15 g of ®ve different puri®ed ®bre-sources (guar, pectin, psyllium, soy polysaccharide, and cellulose), found, that none of these ®bres had a signi®cant effect on breath H 2 and CH 4 . This statement could also be applied on the OB and WB data in the present experiments using the conventional criteria for the H 2 breath test: a sustained increase of more than 20 ppm (Metz et al, 1976), or 10 ppm (Rumessen et al, 1987). These criteria fail to identify malabsorption of small amounts of carbohydrate, especially slowly fermentable carbohydrates, so we used the criterion suggested by Strocchi et al (1993): a sustained increase in end-exp.…”

Section: Discussionmentioning

confidence: 99%

Fermentability of an enzymatically modified solubilised potato polysaccharide (SPP)

et al. 1998

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Objective: To study processing and fermentability in the human gastro-intestinal tract of a newly isolated, enzymatically modi®ed, soluble, and highly concentrated ( b 80% dietary ®bres) solubilised potato ®bre (SPP). Setting: Gastroenterological laboratory. Design, subjects and interventions: Seven healthy volunteers ingested in random order on seven different days: 20 g SPP; bread made of 180 g wheat¯our served with 20 g raw SPP; bread baked of 180 g wheat¯our and 20 g SPP; bread made from 180 g wheat¯our; 20 g lactulose; 20 g oat bran; and 20 g wheat bran. The hydrogen breath test was used to evaluate oro-coecal transit time (OCTT) and fermentation. Results: Fermentation of SPP yielded a measurable increase in end-expiratory H 2 . The total incremental increase in end expiratory H 2 due to SPP was unaffected of whether SPP was served alone, as the raw¯our served with bread, or baked into bread. The OCTT for raw SPP was signi®cantly delayed compared to lactulose (P 0.01). The OCTT for SPP baked into bread was signi®cantly delayed compared to raw SPP (P 0.01), indicating that SPP may be used as a marker of oro-coecal transit time for as well the¯uid phase as the solid phase of a meal. Conclusions: SPP is a fermentable, highly concentrated soluble ®bre source. Baking SPP did not interfere with the fermentable properties. Thus, SPP may be interesting as a ®bre-supplement in ®bre-poor diets. The change in oro-coecal transit time for SPP, depending on the composition of the total meal, makes SPP interesting as a marker in studies of gastrointestinal transit.

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Breath Hydrogen as a Diagnostic Method for Hypolactasia

Cited by 174 publications

References 19 publications

Genetic testing improves the diagnosis of adult type hypolactasia in the Mediterranean population of Sardinia

Genetic testing improves the diagnosis of adult type hypolactasia in the Mediterranean population of Sardinia

Noninvasive Evaluation of Intestinal Lactase with 4-Galactosylxylose: Comparison with 3- and 2-Galactosylxylose and Optimization of the Method in Rats

Fermentability of an enzymatically modified solubilised potato polysaccharide (SPP)

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