In:
European Journal of Gastroenterology & Hepatology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 12 ( 2021-12), p. 1485-1494
Abstract:
While single sugar tests are controversially discussed, combination tests with meals are gaining more attention. The aim of this study was to analyze the impact of adding a test meal to lactulose hydrogen breath tests (LHBT) on hydrogen values and abdominal symptoms in patients with functional gastrointestinal disorders (FGIDs). Methods Data of 81 FGID patients between 2014–2018 were analyzed. Patients underwent LHBT with 30 g lactulose + 300 mL water and a nutrient challenge test (NCT) including 400 mL liquid test meal + 30 g lactulose. To statistically assess the effect of a test meal on abdominal symptoms and H 2 , mixed-effect models were used. Results Adding a test meal to LHBT showed a significant increase in nausea [odds ratio (OR) 1.4; 95% confidence interval (CI), 1.1–1.7], decrease in abdominal pain (OR 0.7; 95% CI, 0.6–0.9), borborygmi (OR 0.5; 95% CI, 0.4–0.6), diarrhea (OR 0.4; 95% CI, 0.3–0.6), and H 2 production (estimate −5.3, SE 0.7, P 〈 0.001). The effect on bloating was only significant in functional dyspepsia, irritable bowel syndrome-functional dyspepsia mixed type and functional abdominal pain/bloating (OR 0.1; 95% CI, 0.0–0.2; OR 1.7; 95% CI, 1.2–2.3 resp OR 4.4; 95% CI, 1.8–10.6). Conclusions Significant effects on abdominal symptoms and H 2 production by adding a test meal to LHBT in FGID patients are shown. Increased occurrence of nausea may be caused by gastric/duodenal hypersensitivity; decreased H 2 , diarrhea and borborygmi by slower and more physiologic gastric emptying resulting in later arrival of the test substance in the bowel. We recommend NCTs instead of LHBT to more physiologically represent FGID patients’ meal-induced burden.
Type of Medium:
Online Resource
ISSN:
0954-691X
DOI:
10.1097/MEG.0000000000002042
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
2030291-5
