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Search Results: 1 - 10 of 13108 matches for " Hydrogen breath test "
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Early peak of hydrogen during lactose breath test predicts intestinal motility  [PDF]
Veronica Ojetti, Teresa Antonella Di Rienzo, Giovanna D’Angelo, Emidio Scarpellini, Gianluca Rizzo, Maria Chiara Campanale, Antonio Gasbarrini
Open Journal of Gastroenterology (OJGas) , 2014, DOI: 10.4236/ojgas.2014.41007
Abstract: Lactose breath test (LBT) is considered the gold standard for the diagnosis of lactose malabsorption. The test is considered positive for a peak of hydrogen (H2) 20 parts per million (ppm) above the baseline. Some patients (pts) showed a rapid peak between 30 and 90 minutes after lactose ingestion. The aim of this study was to evaluate the predictive value of an early peak during a LBT and an accelerated oro-cecal transit time (OCTT). We retrospectively analyzed all pts who referred to our Gastroenterology unit for Irritable Bowel Syndrome, from January to September 2012, who performed LBT, glucose and lactulose breath test. We consider a positive LBT for a peak of H2 > 20 ppm, a positive GHBT for a peak >12 ppm and we considered a normal OCCT a peak of H2 ≥ 10 ppm between 75 ± 105 min after lactulose load. The correlation between LBT and OCTT was evaluated by Pearson score. 93 pts (65 F/28 M mean age 47 ± 6 years) with a positive LBT, without small intestinal bacterial overgrowth were analyzed: 46 pts (32 F/14 M; mean age 48 ± 6 years) with an early peak (<90 min) of H2 (≥20 ppm) were enrolled as case, and 47 pts matched for sex and age with a peak of H2 after 90 min were enrolled as controls. 72% (33/46) of the group with an early peak showed an accelerated, 17% (8/46) a normal and 11% (5/46) a delayed OCTT. Meanwhile, in control group 40.4% (19/47) showed a normal, 57.5% (27/47) a delayed and just 1 pts an accelerated OCTT. The specificity and sensibility of LBT for an accelerated OCTT were 97.9% and 71.7% respectively. The positive predictive value of LBT for an accelerated OCTT is 97.1%; the negative predictive value is 78%. There is a significant correlation between LBT and OCTT (p < 0.05). The presence of an early peak of H2 between 30 and 90 min after the ingestion of 25 gr of lactose could predict the presence of an accelerated OCTT in 97% of pts. If confirmed by further study, in this subset of pts, lactulose breath test for evaluating OCTT could be avoided.
Má absor??o de lactose em crian?as e adolescentes: diagnóstico através do teste do hidrogênio expirado com o leite de vaca como substrato
Pretto, Fernanda M.;Silveira, Themis R.;Menegaz, Virginia;Oliveira, Jarbas de;
Jornal de Pediatria , 2002, DOI: 10.1590/S0021-75572002000300009
Abstract: objective: to determine the prevalence of lactose malabsorption and its association with skin color and age in children and teenagers attending public schools in porto alegre, brazil. methods: a cross-sectional study was performed with 225 subjects between 8 and 18 years attending two public schools in porto alegre, brazil. patients were randomly selected. subjects were classified according to skin color (white and non-white) and age group (8 to 12 and 13 to 18 years). lactose malabsorption was diagnosed using the breath hydrogen test after ingestion of 250 ml of whole cow milk. the test lasted for 3 hours, with collections after fasting and 60, 120, and 180 minutes after milk ingestion. malabsorption was determined in the presence of increase of >20 ppm in hydrogen concentration regarding the basal levels. results: two-hundred and twenty-five students were studied, with a mean age ± standard deviation of 12.2 ± 2.0 years. the subjects consisted of 134 females (59.6%); 154 white (68.4%); and 71 nonwhite. lactose malabsorption was observed in 19/225 cases (8.4%). it was diagnosed in 8/154 white patients (5.2%) and in 11/71 non-white patients (15.5%) (p = 0.02). regarding the age group, we found 15/143 cases of malabsorption in students between 8 and 12 years (10.5%), and 4/82 cases in students between 13 and 18 years (4.9%) (p = 0.227). conclusions: the prevalence of lactose malabsorption in students attending public schools in porto alegre is significant, especially if we consider that the physiological doses (250 ml of milk) were used for diagnosis. the malabsorption rate was higher among non-white children, which confirms the influence of race on primary adult type hypolactasia. no association was observed between lactose malabsorption and age group.
Dietary treatment of colic caused by excess gas in infants: Biochemical evidence
Dámaso Infante,Oscar Segarra,Bernard Le Luyer
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i16.2104
Abstract: AIM: To evaluate the impact of feeding colicky infants with an adapted formula on the hydrogen breath test and clinical symptoms. METHODS: Hydrogen expiration was measured by SC MicroLyzer gas chromatography at inclusion and 15 d after treatment with an adapted low-lactose formula in 20 colicky infants. RESULTS: All babies were symptomatic: 85% with excess gas, 75% with abnormal feeding pattern, and 85% with excessive crying. The hydrogen breath test at inclusion was abnormal: 35 ± 3.1 ppm. After 15 d feeding with an adapted low-lactose formula, crying and flatulence decreased in 85% of patients (P < 0.001). For infants in whom no decrease of gas was reported, crying was still reduced (P < 0.01). Moreover, the feeding pattern was improved in 50% of infants when it was initially considered as abnormal. Finally, the hydrogen breath test decreased significantly (10 ± 2.5 ppm, P < 0.01). CONCLUSION: This study showed an association between clinical improvement and evidence of decreased levels of hydrogen when the infants were fed with a specially designed, low-lactose formula.
Methane production and small intestinal bacterial overgrowth in children living in a slum
Carolina Santos Mello,Soraia Tahan,Lígia Cristina FL Melli,Mirian Silva do Carmo Rodrigues
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i41.5932
Abstract: AIM: To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests. METHODS: This transversal study included 85 children residing in a slum and 43 children from a private school, all aged between 6 and 10 years, in Osasco, Brazil. For characterization of the groups, data regarding the socioeconomic status and basic housing sanitary conditions were collected. Anthropometric data was obtained in children from both groups. All children completed the hydrogen (H2) and methane (CH4) breath test in order to assess small intestinal bacterial overgrowth (SIBO). SIBO was diagnosed when there was an increase in H2 ≥ 20 ppm or CH4 ≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion. RESULTS: Children from the slum group had worse living conditions and lower nutritional indices than children from the private school. SIBO was found in 30.9% (26/84) of the children from the slum group and in 2.4% (1/41) from the private school group (P = 0.0007). Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P = 0.007). A higher concentration of hydrogen in the small intestine (P < 0.001) and in the colon (P < 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO. Methane production was observed in 63.1% (53/84) of the children from the slum group and in 19.5% (8/41) of the children from the private school group (P < 0.0001). Methane production was observed in 38/58 (65.5%) of the children without SIBO and in 15/26 (57.7%) of the children with SIBO from the slum. Colonic production of hydrogen was lower in methane-producing children (P = 0.017). CONCLUSION: Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production. Hydrogen is a substrate for methane production in the colon.
Small intestinal bacterial overgrowth syndrome
Jan Bures, Jiri Cyrany, Darina Kohoutova, Miroslav F?rstl, Stanislav Rejchrt, Jaroslav Kvetina, Viktor Vorisek, Marcela Kopacova
World Journal of Gastroenterology , 2010,
Abstract: Human intestinal microbiota create a complex polymicrobial ecology. This is characterised by its high population density, wide diversity and complexity of interaction. Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequence for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO). SIBO is defined as an increase in the number and/or alteration in the type of bacteria in the upper gastrointestinal tract. There are several endogenous defence mechanisms for preventing bacterial overgrowth: gastric acid secretion, intestinal motility, intact ileo-caecal valve, immunoglobulins within intestinal secretion and bacteriostatic properties of pancreatic and biliary secretion. Aetiology of SIBO is usually complex, associated with disorders of protective antibacterial mechanisms (e.g. achlorhydria, pancreatic exocrine insufficiency, immunodeficiency syndromes), anatomical abnormalities (e.g. small intestinal obstruction, diverticula, fistulae, surgical blind loop, previous ileo-caecal resections) and/or motility disorders (e.g. scleroderma, autonomic neuropathy in diabetes mellitus, post-radiation enteropathy, small intestinal pseudo-obstruction). In some patients more than one factor may be involved. Symptoms related to SIBO are bloating, diarrhoea, malabsorption, weight loss and malnutrition. The gold standard for diagnosing SIBO is still microbial investigation of jejunal aspirates. Non-invasive hydrogen and methane breath tests are most commonly used for the diagnosis of SIBO using glucose or lactulose. Therapy for SIBO must be complex, addressing all causes, symptoms and complications, and fully individualised. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO.
Hydrogen breath test for the diagnosis of lactose intolerance, is the routine sugar load the best one?
Fiorenza Argnani, Mauro Di Camillo, Vanessa Marinaro, Tiziana Foglietta, Veronica Avallone, Carlo Cannella, Piero Vernia
World Journal of Gastroenterology , 2008,
Abstract: AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25.METHODS: Ninety patients showing high-grade malabsorption at HBT-25 were submitted to a second HBT with a lactose load of 12.5 g. Peak hydrogen production, area under the curve of hydrogen excretion and occurrence of symptoms were recorded.RESULTS: Only 16 patients (17.77%) with positive HBT-25 proved positive at HBT-12.5. Hydrogen production was lower as compared to HBT-25 (peak value 21.55 parts per million (ppm) ± 29.54 SD vs 99.43 ppm ± 40.01 SD; P < 0.001). Symptoms were present in only 13 patients. The absence of symptoms during the high-dose test has a high negative predictive value (0.84) for a negative low-dose test. The presence of symptoms during the first test was not useful for predicting a positive low-dose test (positive predictive value 0.06-0.31).CONCLUSION: Most patients with a positive HBT-25 normally absorb a lower dose of lactose and a strict lactose restriction on the basis of a “standard” HBT is, in most instances, unnecessary. Thus, the 25 g lactose tolerance test should probably be substituted by the 12.5 g test in the diagnosis of LI, and in providing dietary guidelines to patients with suspected lactose malabsorption/intolerance.
Usefulness of jejunal biopsy in the study of intestinal malabsorption in the elderly
Lobo,B.; Casellas,F.; Torres,I. de; Chicharro,L.; Malagelada,J. R.;
Revista Espa?ola de Enfermedades Digestivas , 2004, DOI: 10.4321/S1130-01082004000400005
Abstract: background: small bowel structure and function are not different between elderly people and young people. thus, in principle it is advisable to perform diagnostic investigation of elderly patients as well as younger patients when they present with symptoms suggestive of intestinal malabsorption. a key test for the etiologic diagnosis of intestinal malabsorption, jejunal biopsy, has not been specifically examined to assess its usefulness and risk of complications in this advanced age patients. aim: to establish the usefulness of jejunal biopsy with the watson's capsule in the elderly patients with suspected intestinal malabsorption. patients: patients older than 65 years referred to our unit for performance of a jejunal biopsy from 1996 to 2001 for suspicion of intestinal malabsorption. results: forty-seven patients were included. appropriate biopsy sample was obtained in 45 cases, although in 3 patients a second try was required. histologic findings: partial villous atrophy in 10 cases (22.2%), complete villous atrophy in 5 cases (11.1%), intraepithelial lymphocytosis in 5 cases (11.1%), and single cases of intestinal lymphangiectasia, amyloidosis, unspecific jejunitis, and whipple's disease. histology was normal in 19 cases (42%). definitive diagnosis was celiac disease in 14 patients, bacterial overgrowth in 3, jejunitis in 3, whipple's disease in 1, lymphangiectasia in 1, atrophic gastritis in 3, amyloidosis in 1, and ischemic colitis in 1. jejunal biopsy achieved an etiologic diagnosis in 20 patients. there were no cases of perforations or bleeding. conclusion: jejunal biopsy is a useful and safe test for the etiologic diagnosis of intestinal malabsorption in elderly patients.
Correlation between lactose absorption and the C/T-13910 and G/A-22018 mutations of the lactase-phlorizin hydrolase (LCT) gene in adult-type hypolactasia
Bulh?es, A.C.;Goldani, H.A.S.;Oliveira, F.S.;Matte, U.S.;Mazzuca, R.B.;Silveira, T.R.;
Brazilian Journal of Medical and Biological Research , 2007, DOI: 10.1590/S0100-879X2007001100004
Abstract: the c/t-13910 mutation is the major factor responsible for the persistence of the lactase-phlorizin hydrolase (lct) gene expression. mutation g/a-22018 appears to be only in co-segregation with c/t-13910. the objective of the present study was to assess the presence of these two mutations in brazilian individuals with and without lactose malabsorption diagnosed by the hydrogen breath test (hbt). ten milk-tolerant and 10 milk-intolerant individuals underwent the hbt after oral ingestion of 50 g lactose (equivalent to 1 l of milk). analyses for c/t-13910 and g/a-22018 mutations were performed using a pcr-based method. primers were designed for this study based on the genbank sequence. the ct/ga, ct/aa, and tt/aa genotypes (lactase persistence) were found in 10 individuals with negative hbt. the cc/gg genotype (lactase non-persistence) was found in 10 individuals, 9 of them with positive hbt results. there was a significant agreement between the presence of mutations in the lct gene promoter and hbt results (kappa = -0.9, p < 0.001). the ct/aa genotype has not been described previously and seems to be related to lactase persistence. the present study showed a significant agreement between the occurrence of mutations g/a-22018 and c/t-13910 and lactose absorption in brazilian subjects, suggesting that the molecular test used here could be proposed for the laboratory diagnosis of adult-type primary hypolactasia.
Lactose intolerance – current state of knowledge
Edyta M?dry,Ewa Fidler,Jaros?aw Walkowiak
Acta Scientiarum Polonorum : Technologia Alimentaria , 2010,
Abstract: Lactase-phlorizin hydrolase (LCT), more commonly known as lactase, is an enzyme responsible for cleaving lactose into absorbable monosaccharides, glucose and galactose. LCT deficiency (hypolactasia – HL) is caused by a decreased activity of LCT in the small intestinal villi and potentially results in lactose malabsorption what may lead to the development of clinical symptoms (diarrhea, bloating, flatulence and cramps) andavoiding milk products in the diet. HL is the world’s most common enzyme deficiency in humans. HL exists in three distinct forms – congenital, primary and secondary. Adult type hypolactasia (ATH) is the most common phenotype found in human. It is a genetically predetermined physiological condition inherited through an autosomal recessive mode which results in a decline of lactase activity after weaning. ATH is associated with the LCT -13910 C>T polymorphism worldwide, except in Africa. Lactase non-persistence has been observed in individuals with the C/C-13910 genotype, whereas lactase persistence in subjects with remaining allelic variants. Small intestine biopsy is the only diagnostic procedure allowing for the direct measurement of LCT activity, however due to its invasive nature it is hardly accepted by patients. Therefore, LCT status is often inferred simply by assessing the patient’s lactose digestion. A lactose tolerance test can be performed after lactose load and then measuring blood glucose concentration or breath hydrogen (preferably hydrogen and methane) expiration. A genetic test of the C/T-13910 polymorphism is also available at present. It is a reliable method in excluding/confirming ATH predisposition. However, it definitely does not assess lactose tolerance or malabsorption.
Lactose tolerance and intolerance in Malaysians
Peter Michael Barling
International e-Journal of Science, Medicine & Education , 2012,
Abstract: This review explores the digestibility oflactose by Malaysians, and the value of milk and othermilk-derived products as sources of appropriate nutritionfor Malaysians. Increased calcium intake throughconsumption of milk is an effective mechanism forincreasing calcium uptake from the diet and therebyminimising the risk of development of osteoporosis inlater life. Detailed information about rates of lactoseintolerance, and adaptation to dietary lactose andits consequences for Malaysians, will help in theformulation of dietary advice, and improve commerialfood manufaturing practice and Government policydirected to the minimization of rates of osteoporosis,which presents a substantial morbidity risk to elderlyfemale Asians in particular.
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