Clinical Application of a Combined Lactulose H2-breath Test With Abdominal Imaging to Assess Digestive Function in a Retrospective Cohort

What this Trial Is About

Hydrogen breath tests are used to detect carbohydrate malabsorption, measure the time it takes food to move through the intestines (oro-caecal transit time or OCTT), link hydrogen gas increases with abdominal symptoms like bloating and diarrhea, and diagnose small intestinal bacterial overgrowth (SIBO). Differentiating carbohydrate intolerance from SIBO is important because their treatments differ, with dietary changes used for intolerance and antibiotics for SIBO. Recent guidelines question the accuracy of hydrogen breath tests alone for diagnosing SIBO due to variable OCTT measurements, which can cause false positives. This study evaluates a new, simple, and affordable method combining a 20g lactulose hydrogen breath test with abdominal X-ray imaging to confirm OCTT and diagnose SIBO or carbohydrate intolerance. During the test, if hydrogen levels rise before the contrast agent appears in the cecum, SIBO is indicated. If the contrast agent is visible when hydrogen increases, OCTT is confirmed and symptoms after this point suggest carbohydrate intolerance. This approach aims to improve diagnosis without the higher costs and complexity of other imaging techniques. Participants included adults referred for hydrogen breath testing due to digestive symptoms with no organic disease found. During the test, breath hydrogen is monitored while abdominal X-rays are taken when hydrogen rises. Researchers will assess the safety and practicality of this combined test, measure agreement between observers analyzing OCTT, and determine the prevalence of food intolerance and SIBO among participants. The total assessment occurs within three hours during routine clinical care, using existing clinical data with patient consent.

Combined Lactulose H2-breath Test With Abdominal Imaging