Hydrogen breath test of lactose absorption.pdf

original communications The American Journal of Clinical Nutrition 33: MARCH 1980, pp. 545-554. Printed in U.S.A. 545 Hydrogen breath test of lactose absorption in adults: the application of physiological doses and whole cow’s milk sources1’2 Noel W. Solomons,3 Roberto GarcIa-Iba#{241}ez, and Fernando E. Viteri ABSTRACT The absorption of lactose at pharmacological and physiological doses from conventional aqueous solutions and from whole cow’s milk has been studied in healthy adults using a noninvasive hydrogen (H2) breath-analysis technique using thermal conductivity gas chromatography and interval collection of expired air. A discomfort score based on the presence or absence of symptoms (meteorism, flatulence, and diarrhea) during a 6-hr observation period was also recorded. Basal breath H2 concentrations were found to be stable for up to 12 hr. Of 20 subjects available for study, seven showed a rise in breath H2 of 20 ppm after a 50-g aqueous dose of lactose and also experienced no symptoms; they were classified as lactose tolerant absorbers. The remaining 13 individuals experienced some symptoms with this dose and manifested an increment in breath H2 of 20 ppm; they were classified as lactose intolerant mahabsorbers. Follow-up studies using other forms and doses of lactose were conducted in these latter subjects. Fifty grams of lactose as whole mihk produced a significant rise in breath H2 in 10 of the 13 subjects (77%). Nine of the 11 intolerant malabsorbers (82%) ingesting 12.5 g of lactose in aqueous solution showed an increment in breath H2 concentration of 20 ppm, and eight of these nine low dose malabsorbers (89%) also manifested a 20 ppm rise with 12.5 g of lactose as a 25O-ml glass of milk. However, although no significant differences in symptom score were seen between milk and aqueous administration of equivalent doses of lactose, significantly fewer symptoms were experienced with the physiological (12.5 g) dose than with the pharmacological (50 g) dose