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. 2022 Dec 23;13(1):45.
doi: 10.3390/life13010045.

Exhaled Hydrogen after Lactulose Hydrogen Breath Test in Patient with Duodenal Ulcer Disease-A Pilot Study for Helicobacter-pylori-Associated Gastroduodenal Disease

Yi-Hsun Chen  1 , Sharon Chia-Ju Chen  2 , Jiunn-Wei Wang  1   3 , Chiang-Shin Liu  4 , Jeng-Yih Wu  1   3 , Deng-Chyang Wu  1   3 , Yu-Chung Su  1   3
Affiliations

Exhaled Hydrogen after Lactulose Hydrogen Breath Test in Patient with Duodenal Ulcer Disease-A Pilot Study for Helicobacter-pylori-Associated Gastroduodenal Disease

Yi-Hsun Chen et al. Life (Basel). .

Abstract

Objectives: The precipitating mechanism(s) from the inactive to the active stage of duodenal ulcer disease (DU) is unclear. It has been shown that hydrogen gas from colonic fermentation provides an important energy source for Helicobacter pylori (Hp) colonization. The lactulose hydrogen breath test (LHBT) is a useful tool to assess the small intestinal and/or colon fermentation. This study examines the association(s) between the status of gastroduodenal disease and the result of a lactulose hydrogen breath test (LHBT).

Materials and methods: We enrolled Hp-positive active duodenal ulcer (aDU) patients, inactive DU (iDU) patients and patients with a positive Hp infection without structural gastroduodenal lesion, i.e., simple gastritis (SG Hp+). The patients with simple gastritis without Hp infection (SG Hp-) served as controls. Histological examinations of the gastric mucosa and lactulose hydrogen breath test (LHBT) were performed.

Results: SG Hp+ patients tend to have advanced gastritis (pangastritis or corpus-predominant gastritis) compared with SG Hp- patients (7/29 vs. 0/14, p = 0.08). More iDU patients had advanced gastritis than either the SG Hp+ (7/9 vs. 7/29, p = 0.006) or aDU patients (7/9 vs. 6/24, p = 0.013). In comparison with the aDU patients, the iDU patients were also older (52.1 ± 12.6 vs. 42.2 ± 11.9 years, p = 0.02) and had a lower mean area under the curve value of the LHBT(AUC) (209.1 ± 86.0 vs. 421.9 ± 70.9, p = 0.023).

Conclusion: aDU patients with a positive Hp infection have a lower grade of gastric mucosa damage than iDU patients and tend to have a higher level of exhaled hydrogen after LHBT.

Keywords: Helicobacter pylori; duodenal ulcer; lactulose hydrogen breath test.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of advanced gastritis among positive Helicobacter pylori patients. Notes: SG, simple gastritis; aDU, active duodenal ulcer; iDU, inactive duodenal ulcer; Hp, Helicobacter pylori. * p < 0.05.
Figure 2
Figure 2
(A) The presence of SIBO within all subgroups (B) The mean AUC of LHBT within all subgroups. Notes: SIBO, small intestinal bacterial overgrowth; aDU, active duodenal ulcer; iDU, inactive duodenal ulcer; SG, simple gastritis; Hp, Helicobacter pylori; p.p.m., parts per million; LHBT, lactulose hydrogen breath test; AUC, area under the curve. * p < 0.05.
See this image and copyright information in PMC

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