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Breath Hydrogen as a Biomarker for Glucose Malabsorption.pdf

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Breath Hydrogen as a Biomarker for Glucose Malabsorption

Research Article Breath Hydrogen as a Biomarker for Glucose Malabsorption after Roux-en-Y Gastric Bypass Surgery Iman Andalib,1 Hiral Shah,2 Bikram S. Bal,3 Timothy R. Shope,4 Frederick C. Finelli,4 and Timothy R. Koch4 1Department of Medicine, MedStar-Washington Hospital Center and Georgetown University School of Medicine, Washington, DC 20010, USA 2EPGI, Allentown, PA 18104, USA 3Center for Gastrointestinal and Liver Diseases, Centra Southside, Farmville, VA 23901, USA 4Department of Surgery and Center for Advanced Laparoscopic Bariatric Surgery, MedStar-Washington Hospital Center and Georgetown University School of Medicine, Washington, DC 20010, USA Correspondence should be addressed to Timothy R. Koch; timothy.r.koch@ Received 15 July 2015; Revised 8 September 2015; Accepted 17 September 2015 Academic Editor: Fabrizia Bamonti Copyright ? 2015 Iman Andalib et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. Abdominal symptoms are common after bariatric surgery, and these individuals commonly have upper gut bacterial overgrowth, a known cause of malabsorption. Breath hydrogen determination after oral glucose is a safe and inexpensive test for malabsorption. This study is designed to investigate breath hydrogen levels after oral glucose in symptomatic individuals who had undergone Roux-en-Y gastric bypass surgery. Methods. This is a retrospective study of individuals (?? = 63; 60 females; 3 males; mean age 49 years) who had gastric bypass surgery and then glucose breath testing to evaluate abdominal symptoms. Results. Among 63 postoperative individuals, 51 (81%) had a late rise (≥45 minutes) in breath hydrogen or methane, supporting glucose malabsorption; 46 (90%) of these 51 subjects also had an early rise (≤30 minutes) in breath hydrogen or methane supporting upper gut bacterial over