Hydrogen Breath Test (cont.)
Are there other ways in which hydrogen breath
testing can be used?
Antibiotics are used for treating bacterial overgrowth of the small
bowel; however, any one
antibiotic may be effective at eliminating the overgrowing bacteria only
50%-60% of the time. Therefore, if symptoms do not disappear in an individual
following treatment with antibiotics, it may be useful to repeat the breath test
to determine if the antibiotics have eliminated the bacteria. If not, a
different antibiotic or non-antibiotic treatment can be tried.
What are the side effects of hydrogen breath
testing?
The side effects of hydrogen breath testing are exactly what one would
expect to see in individuals who poorly digest and absorb sugars and
carbohydrates, for example, bloating, distention, pain, and diarrhea. When
lactulose is used these symptoms are unlikely to occur or are mild because the
dose of lactulose used for testing is small.
What are the alternatives to hydrogen breath
testing?
For diagnosing lactose
intolerance, an alternative procedure to breath testing requires blood
samples to be taken after the ingestion of lactose. If the digestion and
absorption of lactose is normal, the levels of glucose in the blood should rise.
The elevation of blood glucose
occurs because the lactose is broken down into its two component sugars,
galactose and glucose, as it is absorbed into the blood. A second
alternative is to give a dose of lactose (or other dietary sugar) and observe an
individual for symptoms. If the individual is intolerant, bloating, distention,
pain, flatulence, and diarrhea are likely to occur. A third alternative is a
trial of a diet in which the potentially-offending sugar is strictly eliminated.
All of these alternatives, however, have limitations and problems.
Bacterial overgrowth can be diagnosed by culturing (growing) the bacteria
from a sample of fluid from the small intestine and counting the numbers of
colonic bacteria that are present. This procedure requires a tube to be passed
through the nose,
throat, esophagus and
stomach under X-ray
guidance so that fluid can be obtained from the small intestine. It is an
uncomfortable and expensive procedure, and most laboratories are not able to
accurately culture the samples.
An alternative method for diagnosing rapid transit through the small
intestine involves eating food that is labeled with a
radioactive marker and
determining the time it takes for the marker to reach the colon. Progress of the
marker through the bowel is assessed with a scanner that acts somewhat like a
Geiger counter.
Last Editorial Review: 2/10/2009
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