TY - JOUR
T1 - Detection of malabsorption of low doses of carbohydrate
T2 - Accuracy of various breath H2 criteria
AU - Strocchi, Alessandra
AU - Corazza, Ginoroberto
AU - Ellis, Carol J.
AU - Gasbarrini, Giovanni
AU - Levitt, Michael D.
PY - 1993/11
Y1 - 1993/11
N2 - Background: Although the accuracy of breath H2 testing to detect malabsorption of small (<50 g) doses of carbohydrate has never been evaluated, studies suggest that its accuracy is limited by a high prevalence of "H2 nonproducers." The aim of this study was to determine the accuracy of H2 breath testing in the detection of malabsorption of 10 g of carbohydrate. Methods: In 55 healthy subjects, we determined the ability of breath H2 measurements to distinguish between the ingestion of 10 g of a nonabsorbable carbohydrate (lactulose) and two control meals, a nonabsorbable electrolyte solution or glucose (10 g). Results: The conventional criterion of a 20 ppm increase in breath H2 had 100% specificity but failed to identify lactulose malabsorption in 47% and 24% of subjects at 4 and 8 hours of testing. In contrast, a breath H2 of >6 ppm at 5 or 6 hours had near perfect specificity and sensitivity. A sum of breath H2 at 5, 6, and 7 hours of >15 ppm yielded perfect separation between lactulose and control solutions. Conclusions: True "H2 nonproducers" are extremely rare. Using appropriate criteria, breath H2 testing provides a very accurate means of identifying malabsorption of low doses of carbohydrate.
AB - Background: Although the accuracy of breath H2 testing to detect malabsorption of small (<50 g) doses of carbohydrate has never been evaluated, studies suggest that its accuracy is limited by a high prevalence of "H2 nonproducers." The aim of this study was to determine the accuracy of H2 breath testing in the detection of malabsorption of 10 g of carbohydrate. Methods: In 55 healthy subjects, we determined the ability of breath H2 measurements to distinguish between the ingestion of 10 g of a nonabsorbable carbohydrate (lactulose) and two control meals, a nonabsorbable electrolyte solution or glucose (10 g). Results: The conventional criterion of a 20 ppm increase in breath H2 had 100% specificity but failed to identify lactulose malabsorption in 47% and 24% of subjects at 4 and 8 hours of testing. In contrast, a breath H2 of >6 ppm at 5 or 6 hours had near perfect specificity and sensitivity. A sum of breath H2 at 5, 6, and 7 hours of >15 ppm yielded perfect separation between lactulose and control solutions. Conclusions: True "H2 nonproducers" are extremely rare. Using appropriate criteria, breath H2 testing provides a very accurate means of identifying malabsorption of low doses of carbohydrate.
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U2 - 10.1016/0016-5085(93)90145-3
DO - 10.1016/0016-5085(93)90145-3
M3 - Article
C2 - 8224644
AN - SCOPUS:0027367365
SN - 0016-5085
VL - 105
SP - 1404
EP - 1410
JO - Gastroenterology
JF - Gastroenterology
IS - 5
ER -