Hydrogen and Methane Breath Test in the Diagnosis of Lactose Intolerance

Abstract

The hydrogen (H2) breath test is a non-invasive investigation used to diagnose lactose intolerance (LI). Patients with LI may also expire increased amounts of methane (CH4) during a lactose test. The aim of this study is to evaluate the contribution of CH4 measurements. We tested 209 children (1–17 years old) with symptoms suggesting LI with lactose H2 and CH4 breath tests. The result was positive when the H2 excretion exceeded 20 parts per million (ppm) and the CH4 was 10 ppm above the baseline. A clinician, blinded for the results of the breath test, registered the symptoms. Of the patient population, 101/209 (48%) were negative for both H2 and CH4; 96/209 (46%) had a positive H2 breath test result; 31/96 (32%) were also positive for CH4; 12/209 (6%) patients were only positive for CH4. The majority of hydrogen producers showed symptoms, whereas this was only the case in half of the H2-negative CH4 producers. Almost all patients treated with a lactose-poor diet reported significant symptom improvement. These results indicate that CH4 measurements may possibly be of additional value for the diagnosis of LI, since 5.7% of patients were negative for H2 and positive for CH4, and half of them experienced symptoms during the test.

High-sensitivity methane detection based on QEPAS and H-QEPAS technologies combined with a self-designed 8.7 kHz quartz tuning fork

“…Methane (CH 4 ), as an important carbon-based resource, is closely related to human life and widely utilized in various fields, such as energy [1] , [2] , medical diagnosis [3] , [4] , chemical industry [5] , [6] , and so on. However, CH 4 deserves special attention during extraction, transportation and use.…”

Real-Time Measurement of CH4 in Human Breath Using a Compact CH4/CO2 Sensor

“…Different techniques, including spectroscopic, electrochemical, calorimetric, solidstate and piezoelectric methods, as well as gas chromatography (GC) equipped with a flame-ionization detector (FID) and real-time mass spectrometry, have been applied to monitor CH 4 levels in human breath [3,5,8,9,[12][13][14][15]. There are also commercial instruments available, often in combination with an electrochemical sensor for hydrogen [3].…”

“…Methane is absorbed into the bloodstream and excreted in flatus and breath [ 4 ]. Hydrogen and CH 4 breath tests are nowadays used to assess for carbohydrate malabsorption (e.g., lactose or fructose intolerance) [ 5 ] or small bowel bacterial overgrowth [ 6 , 7 ]. Recently, CH 4 has been found to play a role in gastrointestinal inflammatory diseases and colorectal cancer [ 8 , 9 ].…”

Miniaturized Capsule System Toward Real‐Time Electrochemical Detection of H2S in the Gastrointestinal Tract

“…For instance, elevated hydrogen (H 2 ) and methane (CH 4 ) levels in the breath may suggest lactose intolerance, carbohydrate maldigestion and malabsorption syndromes, and small intestinal bacterial overgrowth (SIBO). [10,11] Hydrogen sulfide (H 2 S) is one of three gasotransmitters in the GI tract and has received significant attention as an endogenous mediator of inflammation, mucosal repair, and homeostasis. [12] Endogenous H 2 S is produced enzymatically (from L-cysteine substrates) in tissues throughout the body, while exogenous H 2 S is produced by intestinal microbiota, such as sulfate-reducing bacteria (SRB).…”

“…Breath testing, analysis of flatus and fecal samples, and endoscopic collection are currently standardized methods for quantifying gut microbial H 2 S production indirectly; however, noninvasive, real-time solutions are lacking. [10,11] Unlike H 2 and CH 4 , H 2 S has a short circulating half-life due to active detoxification and high chemical reactivity, preventing relevant concentrations of intestinal H 2 S from reaching the breath. Moreover, H 2 S produced by oral microbes (e.g., halitosis) can interfere with breath measurements, further complicating the assessment of the H 2 Sproducing metabolism.…”