Breath-Hydrogen Test for Small-Intestinal Bacterial Colonisation

Metz, Geoffrey; Drašar, B. S.; Gassull, M.A.; Jenkins, D. J. A.; Blendis, Laurie

doi:10.1016/s0140-6736(76)92779-3

Cited by 161 publications

(68 citation statements)

References 13 publications

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“…The virtual absence of Lonosaccharide malabsorption in this group of subjects which included severely malnourished children has further clinical implications. Metz et al (19) have shown in adults that an increase in breath H2 after a load of 50 g glucose can be diagnostic of upper intestinal bacterial overgrowth. Severely malnourished Guatemalan children have previously been shown to have bacteria counts in the upper small intestine of lo7 or 10' (18).…”

Section: Discussionmentioning

confidence: 99%

“…Over the last decade, this phenomenon has been exploited to measure the malabsorption of carbohydrate in human subjects. Early clinical studies used closed, rebreathing systems for collection of expired air (1,15), but a procedure of sampling breath at fvted intervals after an oral carbohydrate dose has been employed in adult patients to diagnose hypolactasia (6,9,21), hyposucrasia (20), and bacterial overgrowth (19). Such interval sampling of expired air is inherently noninvasive, and ideally suited for use in children, even infants (17).…”

Section: Speculationmentioning

confidence: 99%

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Development of an Interval Sampling Hydrogen (H2) Breath Test for Carbohydrate Malabsorption in Children: Evidence for a Circadian Pattern of Breath H2 Concentration

1978

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SummaryWe have applied the gas chromatographic analysis of hydrogen (HZ) in expired air to the determination of carbohvdrate malabsorption in children. A compact, inexpensive, a& simple gas chromatograph was specifically adapted to the measurement of low concentration of HZ. A collection procedure using the sampling of expired air at evenly spaced intervals with a low resistance facemask was used to obviate the need for closed, continuous rebreathing systems of breath collection.Under different experimental conditions, HZ concentrations ranged from 11-166 ppm. During fasting, however, Hz concentrations in preschool children were extraordinarily stable and uniform. The velocity of HZ excretion from graded doses of 1.5, 3, and 6 g of the nonabsorbable disaccharide, lactulose, was linear with a response of 1.2 cc Hz/2 hr/g nonabsorbed carbohydrate.Formal clinical lactose tolerance tests were devised using the oral administration of 1.75 g lactose/kg body weight. The increase in HZ concentration was compared with the rise in plasma glucose. Maximum increases in Hz concentration of less than 15 ppm corresponded to a rise in plasma glucose greater than 20 mg/dl; increases in Hz of more than 20 ppm were uniformly accompanied by flat glucose curves. Increases in Hz concentration between 15 and 20 ppm comprised a borderline zone in which both flat and normal glucose curves were seen. The normal absorption of the monosaccharide constituents of lactose, glucose, and galactose, as demonstrated by increments of less than 15 ppm in Hz, indicates that the lactose intolerance was due to failure of digestion of the disaccharide rather than to decreased mucosal absorption of the monosaccharide products.When Hz concentration was measured at 120-min intervals over periods of 24 hr in children on a normal diet, a 2.5-fold or greater increment in breath Hz concentration was observed at some time during nocturnal sleep. Moreover, the increase in HZ concentration to a standard dose of 6 g lactulose was greater during induced sleep than in the awake subject. Various pitfalls to the interpretation of clinical carbohydrate absorption tests using breath Hz were identified. These included an occasionally elevated baseline concentration of Hz, delayed gastric emptying, and previous administration of broad spectrum oral antibiotics. The test is noninvasive, well tolerated, semiquantitative, and ideally suited for use in children. SpeculationThe noninvasive, interval sampling of Hz breath test will provide a more versatile, widely applicable, and better tolerated index of carbohydrate malabsorption in the pediatric population than conventional methods using blood glucose determinations, and will prove to be the preferred method for testing carbohydrate tolerance in children.The methods for studying carbohydrate tolerance generally involve procedures which can be considered mildly to moderately invasive, e.g. sampling of capillary or venous blood for glucose or galactose determination (23). or intestinal intubation and perfusion (16, 29), or un...

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Section: Discussionmentioning

confidence: 99%

Section: Speculationmentioning

confidence: 99%

Development of an Interval Sampling Hydrogen (H2) Breath Test for Carbohydrate Malabsorption in Children: Evidence for a Circadian Pattern of Breath H2 Concentration

1978

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“…In contrast to small bowel aspiration for quantitative culture, breath testing provides a more readily available, safe, inexpensive, and noninvasive alternative to jejunal aspiration culture for the diagnosis of SIBO. The glucose breath test (GBT) was introduced in 1976 in the assessment of SIBO [28]. In an individual with SIBO, the proximally displaced bacteria theoretically should lead to the fermentation of glucose and a resultant increase in breath hydrogen excretion.…”

Section: Small Intestinal Bacterial Overgrowth and Hydrogen Breath Testsmentioning

confidence: 99%

Hydrogen Breath Tests in Gastrointestinal Diseases

Rana

Malik

2014

Ind J Clin Biochem

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Hydrogen breath tests are widely used to explore pathophysiology of functional gastrointestinal (GI) disorders. Small intestinal bacterial overgrowth (SIBO) and carbohydrate malabsorption are disorders detected by these tests that have been proposed to be of great importance for symptoms of GI diseases. Glucose hydrogen breath test is more acceptable for diagnosis of SIBO whereas lactose and fructose hydrogen breath tests are used for detection of lactose and fructose maldigestion respectively. Lactulose hydrogen breath test is also used widely to measure the orocecal transit time for GI motility. These methods are noninvasive and inexpensive. Many patients with func-

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“…Hydrogen measurement is routinely used in human medicine to investigate the gastrointestinal function. This method has been applied successfully to the clinical investigation of small intestinal carbohydrate malabsorption (Levitt and Donaldson 1970;Bond and Levitt 1976), small intestinal bacterial overgrowth (Metz et al 1976) and for the assessment of mouth-to-caecum transit time (Bond et al 1975). The development of portable breath hydrogen monitors may permit cheaper and more practical breath hydrogen measurement to be used as an ancillary test in veterinary practice.…”

mentioning

confidence: 99%

Bacterial overgrowth can be detected by breath hydrogen measurement before clinical manifestations in suckling lambs

Javor¹,

Nagy²,

Papp-Bata³

et al. 2015

Acta Vet. Brno

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Hydrogen breath test is a non-invasive and inexpensive method for estimation of small bowel transit time, detection of excess bacteria in the small intestine and demonstration of maldigestion or malabsorption. Until now, little has been known about breath hydrogen excretion in lambs. The aim of our study was to assess the patterns of breath hydrogen excretion in lambs before and after feeding ewe's milk, and to evaluate pathological and/or physiological alterations in the lambs' gastrointestinal function. We assumed that intestinal disorders may influence the breath hydrogen concentrations, which could be detected early in the subclinical stage. A total of 52 healthy blackheaded Dorper lambs were included in the study. Breath hydrogen was measured after overnight fasting and at 30, 60 and 90 min after the start of feeding. There was a 2-week follow-up period after the measurements to assess the gastrointestinal health of lambs. During the follow-up period, clinical signs of diarrhoea developed in 6 lambs. Based on our results in healthy lambs, the median concentration of baseline breath hydrogen was 1.00 parts per million (minimum: 0.00, maximum: 2.00). We observed a significant elevation in breath hydrogen concentrations 60 min after feeding (P = 0.004), whereas the values detected 30 min after feeding were similar to the baseline values. Regarding the lambs in which clinical signs of diarrhoea developed, we revealed significantly higher baseline breath hydrogen concentrations compared to those which remained healthy (P < 0.001). Our observations underline that hydrogen breath test may be a useful tool for indicating potential bacterial overgrowth before any clinical signs of diarrhoea. Diagnosis, diarrhoea, hydrogen breath test

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Breath-Hydrogen Test for Small-Intestinal Bacterial Colonisation

Cited by 161 publications

References 13 publications

Development of an Interval Sampling Hydrogen (H2) Breath Test for Carbohydrate Malabsorption in Children: Evidence for a Circadian Pattern of Breath H2 Concentration

Development of an Interval Sampling Hydrogen (H2) Breath Test for Carbohydrate Malabsorption in Children: Evidence for a Circadian Pattern of Breath H2 Concentration

Hydrogen Breath Tests in Gastrointestinal Diseases

Bacterial overgrowth can be detected by breath hydrogen measurement before clinical manifestations in suckling lambs

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