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Hydrogen breath tests in gastrointestinal diseases.
REVIEW ARTICLE
Hydrogen Breath Tests in Gastrointestinal Diseases
Satya Vati Rana ? Aastha Malik
Received: 27 January 2014 / Accepted: 19 February 2014 / Published online: 21 March 2014
Association of Clinical Biochemists of India 2014
Abstract Hydrogen breath tests are widely used to
explore pathophysiology of functional gastrointestinal (GI)
disorders. Small intestinal bacterial overgrowth (SIBO) and
carbohydrate malabsorption are disorders detected by these
tests that have been proposed to be of great importance for
symptoms of GI diseases. Glucose hydrogen breath test is
more acceptable for diagnosis of SIBO whereas lactose and
fructose hydrogen breath tests are used for detection of
lactose and fructose maldigestion respectively. Lactulose
hydrogen breath test is also used widely to measure the
orocecal transit time for GI motility. These methods are
noninvasive and inexpensive. Many patients with func-
tional gut disorders are unaware of the relationship
between diet and GI symptoms they present. In particular,
patients with chronic symptoms may regard their condition
as normal and may not be aware that their symptoms can be
effectively managed following a proper diagnosis. Patients
with symptoms of abdominal pain, bloating, flatulence and
altered bowel movements (diarrhea and constipation), or
with a medical diagnosis of irritable bowel syndrome or
celiac disease, may have undiagnosed carbohydrate mal-
absorption or SIBO. Hydrogen breath tests are specific and
sensitive diagnostic tests that can be used to either confirm
or eliminate the possibility of carbohydrate malabsorption
or SIBO in such patients. Breath tests, though valuable
tools, are underutilized in evaluating dyspepsia and func-
tional bloating and diarrhea as well as suspected
malabsorption. However, because of their simplicity,
reproducibility and safety of procedure they are now being
substituted to more uncomfortable and expensive tech-
niques that were traditionally used in gastroenterolog
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