excretion in breath.pdf

ORIGINAL ARTICLE Influence of colectomy on hydrogen excretion in breath Francesc Casellas A. Torrejón J. Vilaseca A. Aparici M. Casaus P. Rodríguez F. Guarner Accepted: 14 October 2009 /Published online: 10 November 2009 # Springer-Verlag 2009 Abstract Introduction Hydrogen breath test is the most commonly used method to analyze carbohydrate absorption and diagnose carbohydrate malabsorption. The result of the H2 breath test is influenced by different factors, which are mostly related to quantitative or qualitative aspects of colonic flora. A scarcely studied variable is the effect of colonic anatomical integrity on H2 excretion in breath. Purpose The present study aims to determine whether loss of colonic integrity reduces H2 excretion capacity after an oral load of an unabsorbable carbohydrate. Methods An observational study was conducted in three patient groups: controls with preserved colon, patients with partial colectomy, and patients with complete colectomy and ileostomy. H2 concentration in breath was measured by gas chromatography every 10 min for 3 h after oral lactulose administration. Results Twenty-two patients with partial colectomy, 18 controls with preserved colon, and seven patients with ileostomy were included. H2 excretion after lactulose did not differ between patients with partial colectomy and controls (basal excretion=8.5 vs 4 ppm; delta increase= 50.0 vs 47.5 ppm; area under the curve=4,480.0 vs 4,710.5 ppm/min). In contrast, H2 excretion was signifi- cantly lower in the ileostomy group. Conclusions Partial colectomy does not influence the capacity for H2 excretion after oral unabsorbable carbohy- drate administration. Keywords Hydrogen breath test . Lactulose breath test . Hydrogen excretion . Colectomy . Ileostomy Study highlights What is current knowledge ? Hydrogen breath test is the gold standard in the diagnosis of carbohydrate malabsorption ? Changes in colonic flora composition may influence hydrogen excretion in breath ? The in