Back to Journals » Clinical and Experimental Gastroenterology » Volume 11

Retrospective analysis of a lactose breath test in a gastrointestinal symptomatic population of Northeast Italy: use of (H2+2CH4) versus H2 threshold

Authors Peron G, Dall'Acqua S, Sorrenti V, Carrara M, Fortinguerra S, Zorzi G, Buriani A

Received 28 January 2018

Accepted for publication 8 March 2018

Published 18 June 2018 Volume 2018:11 Pages 243—248

DOI https://doi.org/10.2147/CEG.S163962

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 4

Editor who approved publication: Prof. Dr. Everson L.A. Artifon


Gregorio Peron,1 Stefano Dall’Acqua,1,2 Vincenzo Sorrenti,1,3 Maria Carrara,1 Stefano Fortinguerra,3 Giulia Zorzi,3 Alessandro Buriani3

1
Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy; 2Unir&d, Nutraceutical Laboratory, Padova, Italy; 3Maria Paola Belloni Center for Personalized Medicine, Data Medica Group, Synlab Limited, Padova, Italy

Background: Lactose malabsorption is normally evaluated by measuring exhaled H2 produced by intestinal flora, from unabsorbed lactose. However, differing microbiome composition can lead to the production of CH4 instead of H2; hence, some authors challenge the H2 method sensitivity and favor the evaluation of both intestinal gases.
Aim: To compare different approaches to usage of a lactose breath test for lactose malabsorption diagnosis, after medical evaluation of gastrointestinal symptoms.
Methods: In a retrospective observational study, we compared the 2 approaches in a population of 282 subjects in Northern Italy. Following oral lactose administration, exhaled samples were harvested every 30 minutes for 4 hours and prepared for H2 and CH4 analysis. Basal gas levels were subtracted from H2 and CH4 ppm and values at 4 hours and peaks were considered for analysis.
Results:
Applying the standard methodology, which takes separately into consideration H2 and CH4 produced in the intestinal lumen, the results indicated that 11.7% of the patients were diagnosed “positive” for hypolactasia, differently from what was expected. Conversely, taking into consideration the sum of H2 and CH4, the percentage increased to 62.8%, closer to the expected one. No significant differences were found when comparing the 2 groups for age, gender, or symptoms. The sizable difference between the 2 approaches is likely linked to gut microbiome variability, and consequently the different production of the 2 gases, in the population.
Conclusion: The threshold normally used for lactose breath test should be reconsidered and changed, merging H2 and CH4 stoichiometric values to increase sensitivity.

Keywords: lactose malabsorption, intestinal malabsorption, hypolactasia, H2+2CH4 threshold

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]