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Table of Contents
Vol. 59, No. 6, 1998
Issue release date: November–December 1998
Digestion 1998;59:696–702
(DOI:10.1159/000007578)

Influence of the Substrate on the Reproducibility of the Hydrogen Breath Test to Measure the Orocecal Transit Time

Casellas F. · Malagelada J.-R.
Digestive System Research Unit, Hospital General Vall d’Hebron, Barcelona, Spain

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Abstract

Background: The H2 breath test is widely used for the measurement of the orocecal transit time (OCTT). However, its clinical applicability is limited by its suboptimal reproducibility. Aim: To investigate whether changes in the substrate for the H2 breath test improve its reliability for the measurement of the OCTT. Methods: 72 consecutive patients referred for measurement of the OCTT were studied. The breath test was performed twice, on consecutive days. One group of patients (‘lactulose + water’ group) received lactulose 13.3 g in water both days. Another group (‘lactulose + diet’) received lactulose 13.3 g in a liquid meal of 400 kcal. A third group (‘lactulose-lactitol’) received 13.2 g of lactulose the first day and 10 g lactitol the following day. The fourth group (‘lactitol + water’) received lactitol 10 g in water both days. Alveolar breath was sampled every 10 min for the next 3 h for H2 chromatography. Results: OCTT in the first and second day test for the groups ‘lactulose + water’, ‘lactulose + diet’ and ‘lactitol + water’ were similar. In these three groups, the values obtained on the first and second day did not differ from 0 and were also significantly correlated. However, the correlation and the mean coefficient of variation were better in group ‘lactulose + water’ than in the groups ‘lactulose + diet’ and ‘lactitol + water’. In group ‘lactulose-lactitol’ the results on both days were significantly correlated although the delta between matched values was different from 0 (p = 0.03). Conclusion: The meal substrate influences the variability of the OCTT. However, reproducibility of the test does not improve with the addition of a liquid meal.



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References

  1. Ohe MR, Camilleri M: Measurement of small bowel and colonic transit: Indications and methods. Mayo Clin Proc 1992;67:1169–1179.
  2. Kellow JE, Borody TJ, Phillips SF, Haddad AC, Brown ML: Sulfapyridine appearance in plasma after salicylazosulfapyridine: Another simple measure of intestinal transit. Gastroenterology 1986;91:396–400.

    External Resources

  3. Malagelada J-R, Robertson JS, Brown ML, Remington M, Duenes JA, Thomforde GM, Carryer PW: Intestinal transit of solid and liquid components of a meal in health. Gastroenterology 1984;87:1255–1263.

    External Resources

  4. Solomons NW: Evaluation of carbohydrate absorption: The hydrogen breath test in clinical practice. Clin Nutr J 1984;3:71–78.
  5. Sciarretta G: Diagnostic value of breath tests in gastroenterology. J Clin Nutr Gastroenterol 1989;4:29–37.
  6. Casellas F, Chicharro L, Malagelada J-R: Potential usefulness of the hydrogen breath test with D-xylose in the clinical management of clinical malabsorption. Dig Dis Sci 1993;38:321–327.
  7. Read NW, Al-Janabi MN, Bates TE, Holgate AM, Cann PA, Kinsman RI, et al: Interpretation of the breath hydrogen profile obtained after ingesting a solid meal containing unabsorbable carbohydrate. Gut 1985;26:834–842.

    External Resources

  8. Bond JH, Levitt MD: Investigation of small bowel transit time in man utilizing pulmonary hydrogen (H2) measurements. J Lab Clin Med 1975;85:575–577.
  9. Tahnghoj H, Jarnerot G: Reproducibility of mouth to caecum transit time determined by hydrogen breath tests after an oral raffinose solution and a test meal. J Clin Nutr Gastroenterol 1989;1:7–10.
  10. Cloarec D, Bruley Des Varannes S, Bizais Y, Lehur PA, Galmiche JP: Reproducibility of mouth to cecum transit time and hydrogen production measured by breath tests. Gastroenterol Clin Biol 1992;16:388–394.
  11. Levitt MD, Hirsh P, Fetzer CA, Sheahan FM, Levine AS: H2 excretion after ingestion of complex carbohydrates. Gastroenterology 1987;92:383–389.
  12. De Vries JJ, Collin T, Bijleveld CMA, Kleibeuker JH, Vonk RJ: The use of complex carbohydrates in barley groats for determination of the mouth-to-caecum transit time. Scand J Gastroenterol 1988;23:905–912.

    External Resources

  13. Caride VJ, Prokop EK, Troncale FJ, Buddoura W, Winchenbach K, McCallum RW: Scintigraphic determination of small intestinal transit time: Comparison with the hydrogen breath technique. Gastroenterology 1984;86:714–720.

    External Resources

  14. Howard PJ, Lazarus C, Maisey MN, Dowling RH: Interpretation of postprandial breath hydrogen excretion in relation to small bowel transit and ileocecal flow patterns of a radiolabeled solid meal in man. J Gastrointest Motil 1990;2:194–201.
  15. Staniforth DH: Comparison of orocecal transit times assessed by the lactulose/breath hydrogen and the sulphasalazine/sulphapyridine methods. Gut 1989;30:978–982.

    External Resources

  16. Gilmore IT: Orocaecal transit time in health and disease. Gut 1990;31:250–251.
  17. Sarno S, Erasmus LP, Haslbeck M, Holzl R: Orocaecal transit time by the H2 method: Effects of definitions of caecal entry and test meal. Ital J Gastroenterol 1993;25:55–64.
  18. La Brooy S, Male PJ, Beavis AK, Misiewicz JJ: Assessment of the reproducibility of the lactulose H2 breath as a measure of mouth to caecum transit time. Gut 1983;24:893–896.
  19. Di Lorenzo C, Dooley CP, Valenzuela JE: Role of fasting gastrointestinal motility in the variability of gastrointestinal transit time assessed by hydrogen breath test. Gut 1991;32:1127–1130.
  20. Riordan SM, McIver CJ, Walker BM, Duncombe VM, Bolin TD, Thomas MC: Bacteriological method for detecting small intestinal hypomotility. Am J Gastroenterol 1996;91:2399–2405.
  21. Cloarec D, Bornet F, Gouilloud S, Barry JL, Salim B, Galmiche JP: Breath hydrogen response to lactulose in healthy subjects: Relationship to methane-producing status. Gut 1990;31:300–304.
  22. Meshkinpour H, Kemp C, Fairshter R: Effect of aerobic exercise on mouth-to-cecum transit time. Gastroenterology 1989;96:938–941.

    External Resources

  23. Camboni G, Basilisco G, Bozzani A, Bianchi PA: Repeatability of lactulose hydrogen breath test in subjects with normal of prolonged orocecal transit. Dig Dis Sci 1988;33:1525–1527.

    External Resources

  24. Rumessen JJ, Hamberg O, Gudmand-Hoyer E: Interval sampling of end-expiratory hydrogen (H2) concentrations to quantify carbohydrate malabsorption by means of lactulose standards. Gut 1990;31:37–42.
  25. Wilberg S, Pieramico O, Malfertheiner P: The H2-lactulose breath test in the diagnosis of intestinal transit time. Leber Magen Darm 1990;20:129–137.
  26. Read NW, Miles CA, Fisher D, Holgate AM, Kime ND, Mitchell MA, et al: Transit of a meal through the stomach, small intestine, and colon in normal subjects and its role in the pathogenesis of diarrhea. Gastroenterology 1980;79:1276–1282.

    External Resources

  27. Holgate AM, Read NW: Relationship between small bowel transit time and absorption of a solid meal. Influence of metoclopramide, magnesium sulfate and lactulose. Dig Dis Sci 1983;28:812–819.

    External Resources

  28. Korth H, Muller I, Erckenbrecht JF, Wienbeck M: Breath hydrogen as a test for gastrointestinal transit. Hepatogastroenterology 1984;31:282–284.

    External Resources

  29. Ladas SD, Latoufis C, Giannopoulou H, Hatzhoannou J, Raptis SA: Reproducible lactulose hydrogen breath test as a measure of mouth-to-cecum transit time. Dig Dis Sci 1989;34:919–924.

    External Resources

  30. Ravich WJ, Bayless TM, Cassilly SR: Variability of breath hydrogen response to lactulose. Gastroenterology 1982;82:1155.
  31. Diggory RT, Cuschieri A: The effect of dose and osmolality of lactulose on the oral-cecal transit time determined by the hydrogen breath test and the reproducibility of the test in normal subjects. Ann Clin Res 1985;17:331–333.

    External Resources

  32. Corbett CL, Thomas S, Read NW, Hobson N, Bergman I, Holdsworth CD: Electrochemical detector for breath hydrogen determination: Measurement of small bowel transit time in normal subjects and patients with the irritable bowel syndrome. Gut 1981;22:836–840.

    External Resources

  33. Waldron B, Cullen PT, Kumar R, Smith D, Jankowski J, Hopwood D, Sutton D, Kennedy N, Campbell FC: Evidence for hypomotility in non-ulcer dyspepsia: A prospective multifactorial study. Gut 1991;32:246–251.
  34. Staniforth DH, Rose D: Statistical analysis of the lactulose/breath hydrogen test in the measurement of orocaecal transit: Its variability and predictive value in assessing drug action. Gut 1989;30:171–175.
  35. O’Brien JD, Thompson DG, Burnham WR, Holly J: Action of centrally mediated autonomic stimulation on human upper gastrointestinal transit: A comparative study of two stimuli. Gut 1987;28:960–969.

    External Resources

  36. Chiarioni G, Scattolini C, Bonfante F, Brengegani MT, Vantini I: Effect of nifedipine on mouth-to-cecum transit of liquid meal in normal subjects. Dig Dis Sci 1993;38:1022–1025.
  37. Pressman JH, Hofmann AF, Witztum KF, Gertler SL, Steinbach JH, Stokes K, Kelts DG, Stone DM, Jones BR, Dharmsathaphorn K: Limitations of indirect methods of estimating small bowel transit in man. Dig Dis Sci 1987;32:689–699.

    External Resources

  38. Bruley des Varannes S, Cherbut C, Schnee M, Delort-Laval J, Galmiche JP: Effects of lactulose on fasting small intestine myoelectrical activity in humans. Eur J Gastroenterol Hepatol 1992;4:539–545.
  39. Casellas F, Accarino AM, Azpiroz F, Malagelada J-R: Prolonged intestinal contractions sparing the distal ileum: A new motility feature stimulated by lactulose. Gastroenterology 1990;98:A334.
  40. Riordan SM, McIver CJ, Walker BM, Duncombe VM, Bolin TD, Thomas MC: The lactulose breath hydrogen test and small intestinal bacterial overgrowth. Am J Gastroenterol 1996;91:1795–1803.


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