Hydrogen–methane breath testing results influenced by oral hygiene

S Erdrich,E.C.K Tan,J.A Hawrelak,S.P Myers,J.E Harnett

doi:10.1016/j.clnesp.2021.09.320

Abstract

Rationale: Criteria for preparation of the oral cavity is not a standard inclusion in current guidelines for hydrogen-methane breath testing. The aim of this study was to determine how a pre-test mouthwash may impact breath test Results upon which diagnosis and treatment recommendations are based.

Highlights

The measurement of hydrogen–methane breath gases is widely used in gastroenterology to evaluate malabsorption syndromes and bacterial overgrowth
Subjects Adult patients (≥ 18 years of age), presenting for hydrogen–methane breath testing for saccharide malabsorption or determination of likelihood of small intestinal bacterial overgrowth (SIBO) were screened for adherence to test preparation, including non-smoking, avoidance of exercise and compliance with a 1-day low residue diet excluding all foods except white rice, fish, chicken, eggs, white bread, clear broths and plain black tea or coffee
Consent for inclusion in our study provided 69 test results for analysis

Summary

Introduction

The measurement of hydrogen–methane breath gases is widely used in gastroenterology to evaluate malabsorption syndromes and bacterial overgrowth. Administration of a chlorhexidine mouthwash resulted in significantly (p ≤ 0.05) reduced breath hydrogen in 67% and/or methane gas in 93% of those consenting to inclusion. In some cases, this modified the diagnosis. Increases in expired breath gases in response to ingestion of non-digestible lactulose, or glucose are used to predict small intestinal bacterial overgrowth (SIBO)[1,2,3,4]. After collection of a baseline breath sample, the challenge substrate (usually lactulose, glucose, fructose, or lactose) is administered, and subsequent samples of breath are collected at pre-determined intervals for the duration of the test period.

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Conclusion