Is the Fat Breath Test Effective in the Diagnosis of Fat Malabsorption and Pancreatic Disease?

Abstract

An attempt was made to evaluate the diagnostic effectiveness of the ¹⁴CO₂-tripalmitin breath test in the screening or diagnosis of fat malabsorption. The differential absorption of ¹⁴C-tripalmitin and palmitic acid was evaluated in the diagnosis of pancreatic insufficiency. 24 controls, 13 patients with steatorrhea and 6 with pancreatic disease (4 of them with insufficiency) were studied. 81 breath tests were performed using 75 ml sour cream as a carrier. In 11 cases the ¹⁴C-tripalmitin test was repeated using 27 g corn oil as carrier. Both the ¹⁴C-tripalmitin and ¹⁴C-palmitic acid breath tests failed to provide any discrimination between normals and patients with fat malabsorption. Variation in type and amount of the carrier fat did not alter these results. ¹⁴C-tripalmitin absorption was distinctly abnormal in the patients with pancreatic insufficiency. The differential absorption of ¹⁴C-tripalmitin and ¹⁴C-ρalmitic acid provided an even better separation between patients with and without pancreatic disease. In contrast to some other investigators we did not find the ¹⁴C-tripalmitin and/or palmitic acid breath tests useful in the diagnosis or screening of fat malabsorption. These tests appear promising in the diagnosis of pancreatic disease.

Estimation of14C-Triolein Assimilation as a Test of Lipid Assimilation

“…4 shows the results of the breath test, calculated as peak quantity of l4CO2 (% of dose/h) (A) and cumulatively expired I4CO2 (% of dose) during the test period (B). Investigations concerning the influence of the test meal on the result of the breath test have not given conclusive results (6,7,9). Furthermore, 14C-triolein was most useful as tracer (1,9,18).…”

Is the ¹⁴C-Triolein Breath Test Useful in the Assessment of Malabsorption in Clinical Practice?

“…Moreover, it requires the patients to follow a standard diet for at least 5 days, usually during hospitalization; it also re quires a fully cooperative patient. More recently, some breath tests using 14C-or 13C-labelled triglycerides have been developed to measure fat malabsorption [1][2][3][4][5] or pancreatic lipolysis [6]; the tests em ploying ,4C-or l3C.-triolein yielded the best results [4,5], The test lasts one whole morn ing, with the patient fasting for 6-8 h after the usual overnight period, and it involves, when l4C is used, long-life isotopes with some en vironmental pollution. It should, therefore, be recommended only if some definite diag nostic usefulness can be foreseeable.…”