Carbohydrate Challenge Tests: Do You Need to Measure Methane?

Knudsen, Christopher; Palma, Jack Di

doi:10.14309/00000434-201010001-00218

Cited by 5 publications

(8 citation statements)

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“…16 We measured both H 2 and CH 4 levels as it has been reported that false negative results occur in 14% of cases when CH 4 is not measured. 17,18 Nevertheless, one limitation of this study was the absence of demonstration of production of H 2 or CH 4 with lactulose prior to patient inclusion in the study. However, lactulose does not seem to be a good test to define a non-hydrogen producer.…”

Section: Discussionmentioning

confidence: 98%

“…The collection of breath samples was carried out according to previous methodological recommendations in order to ensure end‐alveolar breath samples 16 . We measured both H 2 and CH 4 levels as it has been reported that false negative results occur in 14% of cases when CH 4 is not measured 17, 18 …”

Section: Discussionmentioning

confidence: 99%

“…16 We measured both H 2 and CH 4 levels as it has been reported that false negative results occur in 14% of cases when CH 4 is not measured. 17,18…”

Section: Discussionmentioning

confidence: 99%

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Symptomatic fructose malabsorption in irritable bowel syndrome: A prospective study

et al. 2014

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Symptomatic fructose malabsorption in irritable bowel syndrome: A prospective study

et al. 2014

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“…One potential limitation of this study is a lack of methane measurements. Studies have confirmed that sulfur‐metabolizing and methanogenic bacteria can consume hydrogen, and 4% of patients with LM would not have been identified if hydrogen alone was measured without methane . However, another study found that almost half of the patients with constipation‐predominant IBS were methane producers, while none of the patients with IBS‐D produced methane .…”

Section: Discussionmentioning

confidence: 99%

Small intestinal bacterial overgrowth as an uncommon cause of false positive lactose hydrogen breath test among patients with diarrhea‐predominant irritable bowel syndrome in Asia

Wang

Xiong

et al. 2015

J of Gastro and Hepatol

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“…Under either scenario, the CH 4 and H 2 diffuse across the mucosa into the blood stream and ultimately are excreted by the lungs. Hydrogen and CH 4 in the exhaled breath can be easily quantified by a mass spectrometer …”

Section: Diagnosismentioning

confidence: 99%

Gastro 2013 APDW/WCOG Shanghai Working Party Report: Chronic diarrhea: Definition, classification, diagnosis

Schiller

Pardi

Spiller

et al. 2013

J of Gastro and Hepatol

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Diarrhea is best defined as passage of loose stools often with more frequent bowel movements. For clinical purposes, the Bristol Stool Form Scale works well to distinguish stool form and to identify loose stools. Laboratory testing of stool consistency has lagged behind. Acute diarrhea is likely to be due to infection and to be self-limited. As diarrhea becomes chronic, it is less likely to be due to infection; duration of 1 month seems to work well as a cut-off for chronic diarrhea, but detailed scientific knowledge is missing about the utility of this definition. In addition to duration of diarrhea, classifications by presenting scenario, by pathophysiology, and by stool characteristics (e.g. watery, fatty, or inflammatory) may help the canny clinician refine the differential diagnosis of chronic diarrhea. In this regard, a careful history remains the essential part of the evaluation of a patient with diarrhea. Imaging the intestine with endoscopy and radiographic techniques is useful, and biopsy of the small intestine and colon for histological assessment provides key diagnostic information. Endomicroscopy and molecular pathology are only now being explored for the diagnosis of chronic diarrhea. Interest in the microbiome of the gut is increasing; aside from a handful of well-described infections because of pathogens, little is known about alterations in the microbiome in chronic diarrhea. Serological tests have well-defined roles in the diagnosis of celiac disease but have less clearly defined application in autoimmune enteropathies and inflammatory bowel disease. Measurement of peptide hormones is of value in the diagnosis and management of endocrine tumors causing diarrhea, but these are so rare that these tests are of little value in screening because there will be many more false-positives than true-positive results. Chemical analysis of stools is of use in classifying chronic diarrhea and may limit the differential diagnosis that must be considered, but interpretation of the results is still evolving. Breath tests for assessment of carbohydrate malabsorption, small bowel bacterial overgrowth, and intestinal transit are fraught with technical limitations that decrease sensitivity and specificity. Likewise, tests of bile acid malabsorption have had limited utility beyond empirical trials of bile acid sequestrants.

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Carbohydrate Challenge Tests: Do You Need to Measure Methane?

Cited by 5 publications

References 0 publications

Symptomatic fructose malabsorption in irritable bowel syndrome: A prospective study

Symptomatic fructose malabsorption in irritable bowel syndrome: A prospective study

Small intestinal bacterial overgrowth as an uncommon cause of false positive lactose hydrogen breath test among patients with diarrhea‐predominant irritable bowel syndrome in Asia

Gastro 2013 APDW/WCOG Shanghai Working Party Report: Chronic diarrhea: Definition, classification, diagnosis

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