Effect of predominant methanogenic flora on the outcome of lactose breath test in irritable bowel syndrome patients

Vernia, Piero; Camillo, Mauro Di; Marinaro, Vanessa; Caprilli, R.

doi:10.1038/sj.ejcn.1601651

Cited by 44 publications

(17 citation statements)

References 13 publications

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“…Conversely, the increase in H 2 concentrations in expired air was associated with the reduction or suppression of CH 4 excretion. Similar results were observed by Vernia et al [9], in an Italian population. As expected, subjects with predominant CH 4 -producing flora excrete lower amounts of H 2 as compared to low CH 4 producers.…”

Section: Discussionsupporting

confidence: 90%

“…Methane-producing patients likely have a higher ''falsenegative'' rate as compared to LMP after an oral load of lactose. Nonetheless, as symptoms are related to the amount of gas produced in the colon, HBT identifies patients with ''lactose intolerance,'' irrespective of the presence of lactose malabsorption, and helps in predicting the effect of a lactose-restricted diet [9]. Kajs et al [10] investigated the possibility that a variant of the normal colonic flora, a high concentration of methanogens, influences the host's response to ingestion of non-absorbable, fermentable materials.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Predominant Methanogenic Flora on Outcome of Lactose Hydrogen Breath Test in Controls and Irritable Bowel Syndrome Patients of North India

et al. 2008

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The relationship between methanogenic flora and hydrogen (H(2)) production is considered to be a possible confounding factor in the interpretation of hydrogen breath tests (H(2)BT). Therefore, the present study was conducted prospectively and included 154 IBS patients (fulfilling Rome II criteria) and 286 age-and-sex-matched apparently healthy controls. Each subject underwent H(2)BT after overnight fasting using 25 g lactose. Methane and H(2) were measured using an SC Microlyser from Quintron, USA, at baseline and every 30 min for a total of 4 h. Subjects with fasting methane concentration <10 ppm were labeled as low methane producers (LMP) and >10 ppm as predominant methane producers (PMP). A rise >20 ppm over base line in hydrogen concentration was taken as +ve hydrogen breath test. IBS and control groups included 66.78% and 67.53% males, respectively. Mean age in the two groups were 48.52 +/- 30.54 years (range 15-68 years) and 45.67 +/- 30.54 years (range 15-78 years), respectively. Hydrogen breath test was +ve in 77/154 (50%) IBS patients and in 142/286 (49.65%) in controls (P > 0.05). It was also observed that the hydrogen breath test was -ve due to PMP in 5/77 (6.49%) of IBS patients and in 29/154 (20.14%) in controls. PMP affected lactose hydrogen breath tests in 6.49-20.14% subjects. This effect is more apparent in apparently healthy subjects as compared to patients with IBS.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Effect of Predominant Methanogenic Flora on Outcome of Lactose Hydrogen Breath Test in Controls and Irritable Bowel Syndrome Patients of North India

et al. 2008

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“…In our study, the peak values of hydrogen excretion in PMPs also showed lower values than in the LMP group, both in controls as well as in IBS patients. Similar findings have been reported by Vernia et al [7].…”

Section: Discussionsupporting

confidence: 89%

“…A field study was performed to determine the prevalence of lactose malabsorption in Myanmar children and to evaluate the possibility of using breath methane excretion to indicate lactose malabsorption in a field situation [6]. The relationship between hydrogen and methane production is a possible confounding factor in the interpretation of the results of HBTs, but it is usually disregarded and, in most instances, only H 2 excretion is measured [7]. It has been suggested that in methanogenic individuals, breath CH 4 measurement might enhance the accuracy of H 2 breath testing in detecting carbohydrate malabsorption [8].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Predominant Methanogenic Flora in Irritable Bowel Syndrome Patients and Apparently Healthy Controls from North India

et al. 2008

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“…IBS might be a key confounding factor because it is a common entity and its clinical expression, particularly diarrhea-predominant IBS, which includes loose stools, audible bowel sounds, abdominal pain and meteorism resembles the symptoms produced by lactose malabsorption [39,40]. Furthermore, IBS patients might be particularly hypersensitive to lactose compared with healthy individuals [41].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Lactose Intolerance in Chile: A Double-Blind Placebo Study

Latorre

Besa²,

Parodi³

et al. 2014

Digestion

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Background and Study Aims: Lactase non-persistence (LNP), or primary hypolactasia, is a genetic condition that mediates lactose malabsorption and can cause lactose intolerance. Here we report the prevalence of lactose intolerance in a double-blind placebo study. Methods: The LCT C>T_-13910 variant was genotyped by RT-PCR in 121 volunteers and lactose malabsorption was assessed using the hydrogen breath test (HBT) after consuming 25 g of lactose. Lactose intolerance was assessed by scoring symptoms (SS) using a standardized questionnaire following challenge with a lactose solution or saccharose placebo. Results: The LNP genotype was observed in 57% of the volunteers, among whom 87% were HBT(+). In the HBT(+) group the median SS was 9 and in the HBT(-) group the median SS was 3 (p < 0.001). No difference was observed in the SS when both groups were challenged with the placebo. The most common symptoms included audible bowel sounds, abdominal pain and meteorism. In the ROC curve analysis, an SS ≥6 demonstrated 72% sensitivity and 81% specificity for predicting a positive HBT. To estimate prevalence, lactose intolerance was defined as the presence of an SS ≥6 points after subtracting the placebo effect and 34% of the study population met this definition. Conclusions: The LNP genotype was present in more than half of subjects evaluated and the observed prevalence of lactose intolerance was 34%.

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Effect of predominant methanogenic flora on the outcome of lactose breath test in irritable bowel syndrome patients

Cited by 44 publications

References 13 publications

Effect of Predominant Methanogenic Flora on Outcome of Lactose Hydrogen Breath Test in Controls and Irritable Bowel Syndrome Patients of North India

Effect of Predominant Methanogenic Flora on Outcome of Lactose Hydrogen Breath Test in Controls and Irritable Bowel Syndrome Patients of North India

Incidence of Predominant Methanogenic Flora in Irritable Bowel Syndrome Patients and Apparently Healthy Controls from North India

Prevalence of Lactose Intolerance in Chile: A Double-Blind Placebo Study

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