Breath Test OCTT.pdfVIP

Abstract. Orocecal transit time (OCTT) is one of the main determinant of the hunger rat- ings and gastrointestinal sensitivity. While marked-isotopes scintigraphy is the gold standard in its determination in the clinical frame, breath tests are cheap, well-tolerated and non-invasive alternatives. In fact C-13 and C-14 stable isotopes breath tests can be used to assess gastric emptying and OCTT in the clinical and research frames. Moreover, hydrogen (H2) lactulose breath test can be used to assess OCTT in the research frame only due to its laxative action; inulin breath test, devoid of this bias, could be replacing it. However, the main limitation in the use of breath tests in the OCTT determination is their low reproducibility. Keywords: Lactose ureyde, Octanoate, Lactulose, Inulin, OCTT. Introduction Marked isotopes scintigraphy is the gold standard for the assessment of gastric emptying and total OCTT. It is a pretty cheap investiga- tion but quite time consuming and not devoid of limitations for the patient such as its use in pregnant women and children1. In order to over- come these limitations they have been ruled out several stable-isotopes and hydrogen (H2) breath tests2,3 for the determination of gastric emptying, one of the main component of the up- per GI tract motility involved in the control of hunger and nutrient acquisition in man4, and for the total orocecal transit time (OCTT), involved in the regulation of gastrointestinal sensitivity and motility together with the migrating motor complex (MMC)5. This review describes technical and experi- mental/clinical applications of C-13, C-14 and H2 breath tests for the assessment of gastric emptying and OCTT in man. Corresponding Author: Emidio Scarpellini, MD; e-mail: emidio.scarpellini@uniroma1.it 39 C-14 octanoate and C-13 glycine breath tests General principles 14C-octanoic acid breath test (14C-OBT) is able to measure gastric emptying of solids based on6 the retention of 14C-octanoic acid in the solid ph