Abstract
BackgroundHydrogen breath tests are noninvasive procedures frequently applied in the diagnostic workup of functional gastrointestinal disorders. Here, we review hydrogen breath test results and the occurrence of lactose, fructose and sorbitol malabsorption in pediatric patients; and determine the significance of the findings and the outcome of patients with carbohydrate malabsorption.MethodsWe included 206 children (88 male, 118 female, median age 10.7 years, range 3–18 years) with a total of 449 hydrogen breath tests (lactose, n = 161; fructose, n = 142; sorbitol, n = 146) into a retrospective analysis. Apart from test results, we documented symptoms, the therapeutic consequences of the test, the outcome and the overall satisfaction of the patients and families.ResultsIn total, 204 (46%) of all breath tests were positive. Long-term follow-up data could be collected from 118 patients. Of 79 patients (67%) who were put on a diet reduced in lactose, fructose and/or sorbitol, the majority (92%, n = 73) reported the diet to be strict and only 13% (n = 10) had no response to diet. Most families (96%, n = 113) were satisfied by the test and the therapy. There were only 21 tests (5%) with a borderline result because the criteria for a positive result were only partially met.ConclusionsHydrogen breath tests can be helpful in the evaluation of children with gastrointestinal symptoms including functional intestinal disorders. If applied for a variety of carbohydrates but only where indicated, around two-third of all children have positive results. The therapeutic consequences are successfully relieving symptoms in the vast majority of patients.
Highlights
Hydrogen breath tests are noninvasive procedures frequently applied in the diagnostic workup of functional gastrointestinal disorders
Some patients were referred for testing with a single carbohydrate, and many completed a panel of carbohydrate malabsorption tests on different days, including fructose, lactose, and sorbitol
In few patients (2%), the test needed to be interrupted before reaching a definite result based on breath hydrogen because of severe complaints such as pain, vomiting, or diarrhea
Summary
Hydrogen breath tests are noninvasive procedures frequently applied in the diagnostic workup of functional gastrointestinal disorders. We review hydrogen breath test results and the occurrence of lactose, fructose and sorbitol malabsorption in pediatric patients; and determine the significance of the findings and the outcome of patients with carbohydrate malabsorption. Hydrogen breath tests (HBT) are noninvasive investigations frequently used in pediatric gastroenterology. The range of diseases that can be identified include carbohydrate intolerance, small intestinal bacterial overgrowth, and orocecal transit time. When defective sugar absorption is present, unabsorbed carbohydrates make up the substrate for the saccharolitic flora of the colon. The rationale of HBT is based on the concept that part of the gas produced by colonic bacterial fermentation diffuses into the blood and is excreted by breath, where it can be quantified by chromatography [1]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have