Performance and Interpretation of Hydrogen and Methane Breath Testing Impact of North American Consensus Guidelines
© 2022. The Author(s)..
BACKGROUND: Hydrogen and methane breath tests (HMBT) are widely used clinical investigations but lack standardization. To address this, the North American Consensus (NAC) group published evidence-based recommendations for HMBT.
AIMS: To evaluate results obtained using NAC recommendations for HMBT, compared to retrospective data that utilized guidelines previously recommended.
METHODS: HMBT data from 725 patients referred for small intestinal bacterial overgrowth (SIBO) and/or carbohydrate malabsorption (CM) testing were analyzed. Data were compared regarding dose of substrate for SIBO testing (16 vs. 10 g lactulose, and 50 vs. 75 g glucose) and the effect of post-ingestion sampling period for malabsorption testing. The effect of different recommended cut-off values for SIBO were examined.
RESULTS: Substrate dose did not affect methane production. 10 g lactulose significantly reduced positive SIBO results compared to 16 g lactulose (42 vs. 53%, p = 0.04). 75 g glucose significantly increased positive results compared to 50 g glucose (36 vs. 22%, p = 0.04). Provoked symptoms were significantly more prevalent in patients testing positive by both North American Consensus and Ledochowski cut-off values. 34.5% of patients tested positive for CM at 180-min compared to 28% at 120-min (not significant, p = 0.19).
CONCLUSIONS AND INFERENCES: 10 g lactulose substrate produces fewer positive SIBO results than 16 g lactulose, while 75 g glucose dose produces more positive SIBO results than 50 g. Performing CM breath tests for 180 min increases number of positive results when compared to 120 min. SIBO cut-off timings require further investigation, but our findings broadly support the NAC recommendations for SIBO and CM testing.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:67 |
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| Enthalten in: |
Digestive diseases and sciences - 67(2022), 12 vom: 02. Dez., Seite 5571-5579 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pitcher, Charlotte K [VerfasserIn] |
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| Links: |
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| Themen: |
4618-18-2 |
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| Anmerkungen: |
Date Completed 15.11.2022 Date Revised 04.01.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10620-022-07487-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Performance and Interpretation of Hydrogen and Methane Breath Testing Impact of North American Consensus Guidelines |
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| 520 | |a © 2022. The Author(s). | ||
| 520 | |a BACKGROUND: Hydrogen and methane breath tests (HMBT) are widely used clinical investigations but lack standardization. To address this, the North American Consensus (NAC) group published evidence-based recommendations for HMBT | ||
| 520 | |a AIMS: To evaluate results obtained using NAC recommendations for HMBT, compared to retrospective data that utilized guidelines previously recommended | ||
| 520 | |a METHODS: HMBT data from 725 patients referred for small intestinal bacterial overgrowth (SIBO) and/or carbohydrate malabsorption (CM) testing were analyzed. Data were compared regarding dose of substrate for SIBO testing (16 vs. 10 g lactulose, and 50 vs. 75 g glucose) and the effect of post-ingestion sampling period for malabsorption testing. The effect of different recommended cut-off values for SIBO were examined | ||
| 520 | |a RESULTS: Substrate dose did not affect methane production. 10 g lactulose significantly reduced positive SIBO results compared to 16 g lactulose (42 vs. 53%, p = 0.04). 75 g glucose significantly increased positive results compared to 50 g glucose (36 vs. 22%, p = 0.04). Provoked symptoms were significantly more prevalent in patients testing positive by both North American Consensus and Ledochowski cut-off values. 34.5% of patients tested positive for CM at 180-min compared to 28% at 120-min (not significant, p = 0.19) | ||
| 520 | |a CONCLUSIONS AND INFERENCES: 10 g lactulose substrate produces fewer positive SIBO results than 16 g lactulose, while 75 g glucose dose produces more positive SIBO results than 50 g. Performing CM breath tests for 180 min increases number of positive results when compared to 120 min. SIBO cut-off timings require further investigation, but our findings broadly support the NAC recommendations for SIBO and CM testing | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Breath tests | |
| 650 | 4 | |a Fermentation | |
| 650 | 4 | |a Lactulose | |
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| 650 | 7 | |a Glucose |2 NLM | |
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| 700 | 1 | |a Haworth, Jordan J |e verfasserin |4 aut | |
| 700 | 1 | |a Treadway, Sam |e verfasserin |4 aut | |
| 700 | 1 | |a Hobson, Anthony R |e verfasserin |4 aut | |
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