PubMed · 518213
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E R González. 1979. Diagnostic development.. https://doi.org/10.1001/archinte.139.12.1331b
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The authors applied regularly the hydrogen (H2) breath test during the medical investigations in patients with gastrointestinal symptoms. On the basis of the repeated examinations the hydrogen (H2) breath test is a sensitive, well repeatable method. After analysing of 108 examinations the authors have observed in 51.8% lactose intolerance, in 17.8% small intestinal bacterial overgrowth syndrome, in 46.4% motility disorders. The proportion of "low hydrogen producers" was 14.3%. Only 1/5 of patients with new diagnosed lactose intolerance had knowledge about the intolerance, and 10% was asymptomatic. In case of small intestinal bacterial overgrowth syndrome the repeated hydrogen (H2) test may indicate the effectivity of applied antibiotic therapy. The mean orocaecal transit time was 99 minutes and the normal range was 66-132 minutes, counted on the basis of mean +/- 2 SD. The authors suggest that the results support the important role of hydrogen (H2) breath test in the modern gastroenterological diagnostics.
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In the assessment of carbohydrate malabsorption, it is important to determine if patients with a flat breath hydrogen (H2) response to an absorbable carbohydrate challenge are capable of producing H2. We compared the reliability of a rapid faecal incubation system with the lactulose breath test to assess in vivo H2 production in 64 children. Overall, 70% of subjects were in vivo H2-producers, with breath H2 peaks greater than 10 parts per million within 3 h of ingesting 10 g of the non-absorbable disaccharide lactulose. Faecal specimens from the 64 children had a mean (SE) pH of 5.0 (0.077). Faecal homogenates were incubated with lactulose at both the initially measured faecal pH and at neutral pH. In predicting a normal in vivo H2-producing ability (sensitivity), the faecal H2 test was correct in only 22% (faecal pH) to 44% (pH7) of cases. In predicting an abnormal lactulose breath test result (specificity), faecal homogenate analysis was correct in 53% of cases, at both faecal and neutral pH. These findings indicate that the faecal hydrogen test is unsuitable as a screening test for in vivo H2 production.