Follow-up of coeliac disease with the novel one-hour<sup>13</sup>C-sorbitol breath test versus the H<sub>2</sub>-sorbitol breath test

Tveito, Kari; Hetta, Anne Kristine; Askedal, Mia; Brunborg, Cathrine; Sandvik, Leiv; Løberg, Else Marit; Skar, Viggo

doi:10.3109/00365521.2011.575175

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…It is not surprising that testing for disaccharide malabsorption including hydrogen breath testing was introduced early as a potentially useful diagnostic tool for coeliac disease (106). Later reports proposed other BTs, such as the 13 C-sorbitol BT, which, however, did not show any advantage over coeliac disease specific serological tests (55). There is some evidence that the sorbitol BT possibly correlates better with intestinal damage than tissue transglutaminase antibodies (TGA) and antiendomysial antibodies (EMA) (54,107); however, these tests have not been validated.…”

Section: Coeliac Diseasementioning

confidence: 99%

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An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

Broekaert

Borrelli

Dolinšek

et al. 2021

J. pediatr. gastroenterol. nutr.

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Objectives: Given a lack of a systematic approach to the use of breath testing in paediatric patients, the aim of this position paper is to provide expert guidance regarding the indications for its use and practical considerations to optimise its utility and safety. Methods: Nine clinical questions regarding methodology, interpretation, and specific indications of breath testing and treatment of carbohydrate malabsorption were addressed by members of the Gastroenterology Committee (GIC) of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). A systematic literature search was performed from 1983 to 2020 using PubMed, the MEDLINE and Cochrane Database of Systematic Reviews. Grading of Recommendations, Assessment, Development, and Evaluation was applied to evaluate the outcomes. During a consensus meeting, all recommendations were discussed and finalised. In the absence of evidence from randomised controlled trials, recommendations reflect the expert opinion of the authors. Results: A total of 22 recommendations were voted on using the nominal voting technique. At first, recommendations on prerequisites and preparation for as well as on interpretation of breath tests are given. Then, recommendations on the usefulness of H2-lactose breath testing, H2-fructose breath testing as well as of breath tests for other types of carbohydrate malabsorption are provided. Furthermore, breath testing is recommended to diagnose small intestinal bacterial overgrowth (SIBO), to control for success of Helicobacter pylori eradication therapy and to diagnose and monitor therapy of exocrine pancreatic insufficiency, but not to estimate oro-caecal transit time (OCTT) or to diagnose and follow-up on celiac disease. Conclusions: Breath tests are frequently used in paediatric gastroenterology mainly assessing carbohydrate malabsorption, but also in the diagnosis of small intestinal overgrowth, fat malabsorption, H. pylori infection as well as for measuring gastrointestinal transit times. Interpretation of the results can be challenging and in addition, pertinent symptoms should be considered to evaluate clinical tolerance.

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Section: Coeliac Diseasementioning

confidence: 99%

“…Therefore, the HBT is not recommended in clinical practice, while its use may be indicated for research purposes. Some studies have shown superior diagnostic properties when evaluating malabsorption of a 1 hour isotope 13 C-sorbitol BT compared to the HBT (55,56).…”

Section: Recommendationmentioning

confidence: 99%

An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

Broekaert

Borrelli

Dolinšek

et al. 2021

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

show abstract

“…However, it can be used as a quantitative measure of the jejunum’s absorptive capacity during disease follow-up in individual patients. The 13C sorbitol breath test, which has shown superior sensitivity compared to the H 2 -sorbitol breath test during disease follow-up, can also be used to this end in future [ 33 ]. H 2 , hydrogen; HLA, human leukocyte antigen…”

Section: Rational Diagnosis Of Celiac Diseasementioning

confidence: 99%

“…Once the diagnosis of celiac disease has been established, ultrasound – much like other non-invasive tests (e. g., b-D-xylose or 13C sorbitol breath tests) – can be used for follow-up investigations [ 16 , 20 , 32 , 33 ], since the parameters mentioned above can be quantified over time and a response to treatment recognized in the form of, e.g., reduced intestinal wall thickening.…”

Section: Transabdominal Ultrasoundmentioning

confidence: 99%

Modern diagnosis of celiac disease and relevant differential diagnoses in the case of cereal intolerance

et al. 2014

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SummaryAt an incidence of 1:500, celiac disease (formerly sprue) is an important differential diagnosis in patients with malabsorption, abdominal discomfort, diarrhea and food intolerances. Celiac disease can induce a broad spectrum of both gastrointestinal and extraintestinal symptoms, e.g. dermatitis herpetiformis (Duhring’s disease). A variety of oligo- and asymptomatic courses (e.g. anemia, osteoporosis, depression) through to refractory collagenic celiac disease are seen.In HLA-DQ2 and -8 predisposed individuals, celiac disease is provoked by contact with wheat gliadin fractions through a predominantly Th1 immune response and an accompanying Th2 response, which can eventually lead to villous atrophy. Using appropriate serological tests (IgA antibodies against tissue-transglutaminase, endomysium and deamidated gliadin peptides) under sufficient gluten ingestion, the diagnosis can be made more reliably today than previously. The same IgG-based serological tests should be used in the case of IgA deficiency.Diagnosis can either be made in children and adolescents with anti-transglutaminase titers exceeding ten times the standard for two of the above-mentioned serological markers and HLA conformity or it is made by endoscopy and histological Marsh classification in adults and in cases of inconclusive serology. If clinically tolerated, gluten challenges are indicated in patients that already have reduced gluten intake, in borderline serological results, discordance between serological and histological results or in suspected food allergy.The diagnosis of celiac disease needs to be definitive and robust before establishing a gluten-free diet, since lifelong abstention from gluten (gliadin < 20 mg/kg foodstuffs), cereal products (wheat, rye, barley and spelt) as well as from preparations and beverages containing gluten, is necessary. With effective elimination of gluten, the prognosis regarding complete resolution of small bowel inflammation is good. Refractory courses are seen only in rare cases, accompanied by enteropathy-associated T-cell lymphoma.

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Moderne Diagnostik der Zöliakie und relevante Differenzialdiagnosen bei Getreideunverträglichkeiten

et al. 2014

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Follow-up of coeliac disease with the novel one-hour¹³C-sorbitol breath test versus the H₂-sorbitol breath test

Abstract: The study confirms the sensitivity of a one-hour (13)C-SBT for small intestinal malabsorption. The (13)C-SBT has superior diagnostic properties compared with the H(2)-SBT in follow-up of coeliac disease.

Cited by 3 publications

References 24 publications

An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

Modern diagnosis of celiac disease and relevant differential diagnoses in the case of cereal intolerance

Moderne Diagnostik der Zöliakie und relevante Differenzialdiagnosen bei Getreideunverträglichkeiten

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Follow-up of coeliac disease with the novel one-hour13C-sorbitol breath test versus the H2-sorbitol breath test

Abstract: The study confirms the sensitivity of a one-hour (13)C-SBT for small intestinal malabsorption. The (13)C-SBT has superior diagnostic properties compared with the H(2)-SBT in follow-up of coeliac disease.

Cited by 3 publications

References 24 publications

An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

Modern diagnosis of celiac disease and relevant differential diagnoses in the case of cereal intolerance

Moderne Diagnostik der Zöliakie und relevante Differenzialdiagnosen bei Getreideunverträglichkeiten

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Follow-up of coeliac disease with the novel one-hour¹³C-sorbitol breath test versus the H₂-sorbitol breath test