Proton Pump Inhibitor Therapy Does Not Affect Hydrogen Production on Lactulose Breath Test in Subjects with IBS

Law, David; Pimentel, Mark

doi:10.1007/s10620-009-1010-2

Cited by 30 publications

(20 citation statements)

References 31 publications

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“…As hyperventilation inversely affects H 2 levels (35), excessive physical activity should be avoided during the breath test. Conflicting results exist in the literature in regards to the effect of proton pump inhibitors (PPIs) on breath test results (36, 37). Stopping PPIs may not lead to more accurate measurements of exhaled breath gas levels and recurrence of reflux symptoms may not be tolerable to all patients.…”

Section: Resultsmentioning

confidence: 99%

“…It should be noted that in the presence of SIBO, fructose and lactose are prematurely exposed to excessive small intestinal bacterial composition that will lead to early fermentation and elevation of exhaled gases (36, 64, 84, 85). Therefore, performance of a lactulose or glucose breath test to rule-out SIBO should be considered prior to carbohydrate malabsorption breath testing to minimize false positive results.…”

Section: Resultsmentioning

confidence: 99%

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Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Rezaie

Buresi

Lembo

et al. 2017

American Journal of Gastroenterology

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597

734

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Objectives:Breath tests (BTs) are important for the diagnosis of carbohydrate maldigestion syndromes and small intestinal bacterial overgrowth (SIBO). However, standardization is lacking regarding indications for testing, test methodology and interpretation of results. A consensus meeting of experts was convened to develop guidelines for clinicians and research.Methods:Pre-meeting survey questions encompassing five domains; indications, preparation, performance, interpretation of results, and knowledge gaps, were sent to 17 clinician-scientists, and 10 attended a live meeting. Using an evidence-based approach, 28 statements were finalized and voted on anonymously by a working group of specialists.Results:Consensus was reached on 26 statements encompassing all five domains. Consensus doses for lactulose, glucose, fructose and lactose BT were 10, 75, 25 and 25 g, respectively. Glucose and lactulose BTs remain the least invasive alternatives to diagnose SIBO. BT is useful in the diagnosis of carbohydrate maldigestion, methane-associated constipation, and evaluation of bloating/gas but not in the assessment of oro-cecal transit. A rise in hydrogen of ≥20 p.p.m. by 90 min during glucose or lactulose BT for SIBO was considered positive. Methane levels ≥10 p.p.m. was considered methane-positive. SIBO should be excluded prior to BT for carbohydrate malabsorption to avoid false positives. A rise in hydrogen of ≥20 p.p.m. from baseline during BT was considered positive for maldigestion.Conclusions:BT is a useful, inexpensive, simple and safe diagnostic test in the evaluation of common gastroenterology problems. These consensus statements should help to standardize the indications, preparation, performance and interpretation of BT in clinical practice and research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Rezaie

Buresi

Lembo

et al. 2017

American Journal of Gastroenterology

Self Cite

597

734

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“…Several studies have evaluated this effect and have come to conflicting conclusions [43][44][45][46][47][48][49]. Ratuapli et al [45] reported no association between PPI use and SIBO in a cohort of 1191 patients utilizing glucose hydrogen breath testing.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of the possible association between pharmacological gastric acid suppression and spontaneous bacterial peritonitis

Khan

Kamal

Khan³

et al. 2015

European Journal of Gastroenterology &Amp; Hepatology

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“…Another issue was the inclusion of subjects using proton pump inhibitors (PPI) [31]. While a recent study refuted the influence of PPI on breath testing [32], there was still some heterogeneity among the selected papers with regards to inclusion of subjects on PPI. Only two studies excluded patients based on previous use of proton pump inhibitors [26] or anti-secretive therapy [28].…”

Section: Study Heterogeneitymentioning

confidence: 99%

Abnormal Breath Testing in IBS: A Meta-Analysis

et al. 2010

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Proton Pump Inhibitor Therapy Does Not Affect Hydrogen Production on Lactulose Breath Test in Subjects with IBS

Abstract: PPI therapy does not effect hydrogen production on lactulose breath tests in IBS patients. However, there may be an effect on methane.

Cited by 30 publications

References 31 publications

Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus

Systematic review and meta-analysis of the possible association between pharmacological gastric acid suppression and spontaneous bacterial peritonitis

Abnormal Breath Testing in IBS: A Meta-Analysis

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