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Comparative Study
. 2015 Sep 7;7(9):7469-85.
doi: 10.3390/nu7095348.

Additional Value of CH₄ Measurement in a Combined (13)C/H₂ Lactose Malabsorption Breath Test: A Retrospective Analysis

Els Houben  1   2 , Vicky De Preter  3   4 , Jaak Billen  5 , Marc Van Ranst  6   7 , Kristin Verbeke  8   9
Affiliations
Comparative Study

Additional Value of CH₄ Measurement in a Combined (13)C/H₂ Lactose Malabsorption Breath Test: A Retrospective Analysis

Els Houben et al. Nutrients. .

Abstract

The lactose hydrogen breath test is a commonly used, non-invasive method for the detection of lactose malabsorption and is based on an abnormal increase in breath hydrogen (H₂) excretion after an oral dose of lactose. We use a combined (13)C/H₂ lactose breath test that measures breath (13)CO₂ as a measure of lactose digestion in addition to H₂ and that has a better sensitivity and specificity than the standard test. The present retrospective study evaluated the results of 1051 (13)C/H₂ lactose breath tests to assess the impact on the diagnostic accuracy of measuring breath CH₄ in addition to H₂ and (13)CO₂. Based on the (13)C/H₂ breath test, 314 patients were diagnosed with lactase deficiency, 138 with lactose malabsorption or small bowel bacterial overgrowth (SIBO), and 599 with normal lactose digestion. Additional measurement of CH₄ further improved the accuracy of the test as 16% subjects with normal lactose digestion and no H₂-excretion were found to excrete CH₄. These subjects should have been classified as subjects with lactose malabsorption or SIBO. In conclusion, measuring CH₄-concentrations has an added value to the (13)C/H₂ breath test to identify methanogenic subjects with lactose malabsorption or SIBO.

Keywords: breath test; hydrogen; lactase deficiency; lactose malabsorption; methane; stable isotopes.

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Figures

Figure 1
Figure 1
Percentage of CH4 producers in fasting state as function of body mass index (BMI) (a) and correlation between fasting CH4 and BMI (b).
Figure 2
Figure 2
Percentage of subjects that reported discomfort after performing a 13C/H2 breath test.
Figure 3
Figure 3
Percentage of subjects that reported discomfort within the subjects with lactase deficiency.
Figure 4
Figure 4
Percentage of subjects diagnosed with lactose malabsorption or SIBO that reported discomfort.
Figure 5
Figure 5
Percentage of subjects with normal lactose digestion that report discomfort.
See this image and copyright information in PMC

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