Alterations of the colonic flora and their effect on the hydrogen breath test.

Gilat, Tuvia; Hur, Hyuk; Gelman-Malachi, E; Terdiman, Reuven; Peled, Y

doi:10.1136/gut.19.7.602

Cited by 173 publications

(70 citation statements)

References 8 publications

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“…The large differences between populations in the percentage of those failing to manifest a rise in breath H2 despite administration of lactulose, e.g., 20% in Israel (26) vs. 2% in the U. S. (27), may be due to differences in fecal pH caused by regional diets.…”

Section: Discussionmentioning

confidence: 99%

“…There were four females and one male, ranging in age from 26 to 40 yr. None excreted methane (<1 ppm CH4 above room air in expired air) as determined by mass spectrometry as described below. Methane excretors were excluded because their H2 response to intake of a nonabsorbable carbohydrate may be different from the non-CH4 excreting population (13).…”

Section: Human Subjectsmentioning

confidence: 99%

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Role of pH in production of hydrogen from carbohydrates by colonic bacterial flora. Studies in vivo and in vitro.

Perman¹,

Modler²,

Olson³

1981

J. Clin. Invest.

191

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A B S T R A C T Hydrogen produced by colonic bacteria and excreted in breath is a useful index ofcarbohydrate malabsorption. Since colonic contents are often acidic in individuals with carbohydrate malabsorption and in normal newborns, we determined the effect of colonic acidification on H2 production. Acidification of colonic contents by dietary means significantly reduced excess breath H2 excretion from 55.4+ 11.1 (SEM) to 12.2 ±3.1 ml/4 h (P < 0.05) after administration of 0.3 g/kg of the nonabsorbable sugar lactulose to five normal adult subjects. Similarly, the breath H2 response to lactose was reduced or eliminated in two proven lactose malabsorbers after acidification. The correlation between pH and H2 production from carbohydrate was further investigated in adults and neonates, using an in vitro fecal incubation system. Glucose disappearance and H2 production were pH dependent and highly correlated (r = 0.94) in the pH range 5.5-7.6. Maximal production of H2 from glucose by fecal incubates occurred at pH 7.0-7.45. Inhibition of H2 production from carbohydrate occurred at acid pH. H2 per hour from glucose at pH 6.2 and 5.5 averaged 60.2% and 24.2%, respectively, of that produced at neutral pH. Rapid reversal of pH-induced inhibition by neutralization indicated a metabolic, rather than a bactericidal process. The observations indicate that the breath H2 response to malabsorbed carbohydrate is affected by colonic pH. It appears that the efficiency of bacterial carbohydrate metabolism in the colon is pH dependent.

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Section: Discussionmentioning

confidence: 99%

Section: Human Subjectsmentioning

confidence: 99%

Role of pH in production of hydrogen from carbohydrates by colonic bacterial flora. Studies in vivo and in vitro.

Perman¹,

Modler²,

Olson³

1981

J. Clin. Invest.

191

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“…The inability of many individuals to elevate their breath H2 excretion despite documented carbohydrate malabsorption (29,30) limits the applicability and interpretation of H2 breath tests. This phenomenon has been attributed to a lack of a H2 producing flora.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting hydrogen production and consumption by human fecal flora. The critical roles of hydrogen tension and methanogenesis.

Strocchi¹,

Levitt²

1992

J. Clin. Invest.

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We studied the influence of hydrogen tension (PH2) and methanogenesis on H2 production and consumption by human fecal bacteria. Hydrogen consumption varied directly with PH2, and methanogenic feces consumed H2 far more rapidly than did nonmethanogenic feces. At low PH2, H2 production greatly exceeded consumption and there was negligible accumulation of the products of H2 catabolism, methane and sulfide. Thus, incubation at low PH2 allowed the first reported measurements of absolute as opposed to net H2 production. Feces incubated at high and intermediate PH2 had a net H2 production of only 1/900 and 1/64 of absolute production. Glucose fermentation by fecal bacteria yielded an absolute H2 production of 80 ml/g, a value far in excess of that excreted by volunteers ingesting lactulose. We conclude that most H2 produced by colonic bacteria is consumed and methanogenesis and fecal stirring (via its influence on fecal PH2) are critical determinants of H2 consumption and, hence, net H2 production. Study of fecal samples from four subjects with low breath H2 excretion after lactulose showed that absolute H2 production was normal, and the low H2 excretion apparently reflected increased consumption due to rapid methanogenesis (two subjects) and decreased luminal stirring (two subjects). (J. Clin. Invest. 1992. 89:1304-1311

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“…Table 1 shows the comparison of height, weight, and BMI values between Thai and Japanese subjects. All participants were non-smokers and were required to report any antibiotic therapy received during the year (Gilat et al, 1978). Subjects underwent the breath hydrogen test in the follicular phase of their menstrual cycles, because the menstrual cycle can affect gastrointestinal activity (Wald et al, 1981).…”

Section: Subjectsmentioning

confidence: 99%

Seasonal Variation in Amount of Unabsorbed Dietary Carbohydrate from the Intestine after Breakfast in Young Female Thai Subjects:Comparison with that of Japanese Subjects

Tsumura

Makonakwkeyoon

Limtrakul

et al. 2010

J Physiol Anthropol

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Previously, using the breath hydrogen test, we investigated seasonal variations in the amount of unabsorbed dietary carbohydrate from the intestine after breakfast in female Japanese university students and young Polish subjects. In the study we found that there were significant seasonal variations in both countries with the smallest unabsorbed dietary carbohydrate in autumn and the biggest in winter. Considering the theory of human adaptation to living environments, we suggested a hypothesis that this seasonal variation in the efficiency of carbohydrate absorption in the intestine may reflect human adaptation and/or a response to seasonal change in the living environment. In order to prove this hypothesis, we carried out the same examination in Chiang Mai, Thailand, where there is different seasonal change in the living environment from that of Japan and of Poland. In this examination, we measured the amount of unabsorbed dietary carbohydrate (UDC) from the intestine after breakfast and the oro-cecal transit time (OCTT) of the breakfast in female Thai university students using the same method and experimental protocol as previously carried out with Japanese subjects. We conducted the examination in April (the hot season), in August-September (the rainy season), and in NovemberDecember (the dry season) of 2008, at the Medical School of Chiang Mai University, Chiang Mai. The results are summarized as follows: (1) there were no significant seasonal variations in the amounts of unabsorbed dietary carbohydrate from breakfast in Thai subjects; (2) there were no significant seasonal variations in the oro-cecal transit times of breakfast or a soluble indigestible trisaccharide (lactosucrose) solution in Thai subjects; (3) there were no significant differences in the oro-cecal transit times of breakfast between the two countries in any season; (4) the UDC of Thai subjects was significantly less than that of the Japanese subjects in the three seasons. These results suggest that differences in seasonal change in a living environment have different effects on seasonal variations in the efficiency of carbohydrate absorption in the intestine after breakfast.

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Alterations of the colonic flora and their effect on the hydrogen breath test.

Cited by 173 publications

References 8 publications

Role of pH in production of hydrogen from carbohydrates by colonic bacterial flora. Studies in vivo and in vitro.

Role of pH in production of hydrogen from carbohydrates by colonic bacterial flora. Studies in vivo and in vitro.

Factors affecting hydrogen production and consumption by human fecal flora. The critical roles of hydrogen tension and methanogenesis.

Seasonal Variation in Amount of Unabsorbed Dietary Carbohydrate from the Intestine after Breakfast in Young Female Thai Subjects:Comparison with that of Japanese Subjects

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