The Cholyl Glycine-1-¹⁴C Breath Test in Various Gastrointestinal Disorders

Abstract

The cholyl glycine-1-¹⁴C breath test was evaluated in a variety of gastrointestinal disorders. 138 tests were performed in 106 patients. Methods of data expression were evaluated and the cumulative 8-hour value was used. In 27 control patients the upper limit of the normal was found to be 78. A good correlation was found between the peak values and the cumulative 8-hour values (r = 0.95, p < 0.01). The reproducibility of the test was good (r = 0.985, p < 0.05). Abnormal results were found in 12 out of 13 cases with resection of the ileum and 11 out of 14 cases with Crohn’s disease of the distal small bowel. The test was normal in cases with diseases of the proximal small bowel (celiac, Whipple’s and Crohn’s diseases). The test was also normal in patients with colitis. It was abnormal in some of the cases after cholecystectomy and in most cases with carcinoma of the pancreas. The breath test was useful in monitoring the results of treatment in bacterial overgrowth of the small bowel. False negative results were observed after antibiotic treatment. The method seems to be more sensitive than the Schilling test in diagnosing disease of the distal small bowel.

Evaluation of small bowel bacterial overgrowth

“…Breath tests based on deconjugation of isotopically labeled glycocholate or glycotaurate have also been described [18,36,37]. These tests depend on cleavage of the conjugated bile acid by enteric bacteria and metabolism of the freed (labeled) glucose entity to labeled CO 2 .…”