Breath testing to evaluate lactose intolerance in irritable bowel syndrome correlates with lactulose testing and may not reflect true lactose malabsorption

Pimentel, Mark; Kong, Yuthana; Park, Sandy
December 2003
American Journal of Gastroenterology;Dec2003, Vol. 98 Issue 12, p2700
Academic Journal
OBJECTIVES: An increased prevalence of lactose intolerance is seen in irritable bowel syndrome (TB 5). Recently, we demonstrated a high prevalence of abnormal lactulose breath test results in lBS suggesting bacterial overgrowth. Because symptoms of lactose intolerance result from bacterial fermentation, the purpose of this study was to determine whether an abnormal lactose breath test is reflective of malabsorption or early presentation to bacteria. METHODS: Subjects with diarrhea-predominant lBS were enrolled. On day 1, subjects underwent a lactulose breath test after an overnight fast. Within 1 wk, subjects returned after fasting for a lactose breath test with simultaneous blood glucose measurements every 15 mm to complete a lactose tolerance test (LTT). Symptoms were evaluated 3 h after lactose administration. RESULTS: Twenty subjects completed the study. One subject inadvertently received dextrose through the intravenous and was excluded. Of the remaining 19 subjects, three (16%) had an abnormal LTT suggesting malabsorption. In all, 10 subjects (53%) had an abnormal lactose breath test, 14 (74%) had an abnormal lactulose breath test, and 11(58%) had symptoms after lactose administration. The agreement with symptoms was moderate (κ = 0.47) and fair (κ = 0.24) when compared to the lactose breath test and LTT, respectively. There was a fair correlation between lactose breath test and LTT (κ = 0.29). However, lactose breath test hydrogen levels >166 ppm were universally predictive of abnormal LTT. Finally, a significant correlation was seen between the hydrogen production on lactose and lactulose breath test (r = 0.56, p = 0.01). CONCLUSIONS: Lactose breath testing in lBS subjects does not seem to reflect malabsorption; it may be an indicator of abnormal lactulose breath test, suggesting bacterial overgrowth.


Related Articles

  • Lactulose in baby milks causing diarrhoea simulating lactose intolerance. Hendrickse, R.G.; Wooldridge, M.A.W.; Russell, A. // British Medical Journal;5/7/1977, Vol. 1 Issue 6070, p1194 

    Examines the simulation of lactose intolerance in baby milk lactulose causing diarrhea in Great Britain. Complications of acquired lactose intolerance; Diagnosis of lactose intolerance; Presence of lactulose in prepacked liquid milk.

  • Soothe Your Savage Gut. Metcalf, Eric; Harrar, Sari // Prevention;May2002, Vol. 54 Issue 5, p44 

    Focuses on how eliminating dairy products from a diet can eliminate symptoms of irritable bowel syndrome for the lactose-intolerant.

  • Lactose intolerance symptoms heightened by visceral hypersensitivity and gas production in IBS patients.  // Gastrointestinal Nursing;Sep2013, Vol. 11 Issue 7, p6 

    The article discusses research on a connection between inflammatory bowel syndrome (IBS) patients and lactose intolerance (LI), by Yujin Zhu et al., which was published in the 2013 issue of the "American Journal of Gastroenterology." It indicates that LI symptoms are likely to be experienced by...

  • Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome: a double-blind, randomized, placebo-controlled study Pimentel, Mark; Chow, Evelyn J.; Lin, Henry C. // American Journal of Gastroenterology;Feb2003, Vol. 98 Issue 2, p412 

    : ObjectiveWe have recently found an association between abnormal lactulose breath test (LBT) findings and irritable bowel syndrome (IBS). The current study was designed to test the effect of antibiotic treatment for IBS in a double-blind fashion.: MethodsConsecutive IBS subjects underwent an...

  • You asked for it. Hunter, Beatrice Trum // Consumers' Research Magazine;Oct94, Vol. 77 Issue 10, p9 

    Presents an advisory on nutrition and food. Candy bar with label stating that it was licorice-like flavored; Alcohol content in sweeteners; Blood sugar increase with non-fat ice cream or sherbet; Lactose intolerance.

  • ask us.  // Diabetes Forecast;Jul2002, Vol. 55 Issue 7, p21 

    Answers questions on diabetes. Options for diabetic persons to avoid discomforts caused by lactose intolerance; Reasons behind the difference in A1C readings and blood sugar readings.

  • No milk today. Harris, M D // BMJ: British Medical Journal (International Edition);9/15/2001, Vol. 323 Issue 7313, p640 

    Relates the author's experience being diagnosed as lactose intolerant. His original diagnosis of irritable bowel syndrome; Details of lactose intolerance; How adult consumption of milk is a relatively recent phenomenon in human evolution; Suggestion that many cases of lactose intolerance may be...

  • SUBJECTIVE LACTOSE INTOLERANCE IN APPARENTLY HEALTHY ADULTS IN SOUTHERN IRAN: IS IT RELATED TO IRRITABLE BOWEL SYNDROME? Saberi-Firoozi, M.; Khademolhosseini, F.; Mehrabani, D.; Yousefi, M.; Salehi, M.; Heidary, S. T. // Indian Journal of Medical Sciences;Nov2007, Vol. 61 Issue 11, p591 

    BACKGROUND: The main symptoms of lactose intolerance are bloating, abdominal cramps, increased flatus and loose watery stools. These symptoms are similar to those of irritable bowel syndrome (IBS), which is a prevalent entity in the community. OBJECTIVE: As there was no data available on the...

  • Probiotics: Don't let it bug you. Lambert, Lynn // South African Pharmacist's Assistant;Spring2016, Vol. 16 Issue 3, p32 

    The article discusses how probiotics, described as good bacteria, benefit the gastrointestinal tract (GIT), its health benefits such as diarrhoea prevention and treatment, immune system enhancement and lactose intolerance alleviation, and indications of probiotics, based on clinical studies.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics