Comparison of Oro-Cecal Transit Time by Hydrogen Breath Test and Radionuclide Scintigraphy

Moon, Jeong Seop; song, Chi Wook; Choe, Jae Gol; Hyun, Jin Hae

Abstract

BACKGROUND AND AIMS: Patients with gastrointestinal symptoms, and motility disorclers are considered a main part of disease entities. Various motility tests have been used but the motility of the small bowel is hard to evaluate directly. Measurement of oro-cecal transit time u:;ing the hydrogen breath test has been used for the evaluation of small bowel motility, but critericn to indicate cecal arrival was different arnong many studies. We aimed to identify the criterion of cecal amval in hydrogen breath test compared with radionuclide scintigraphy.
METHODS
Subjects were 30 volunteers with no gastrointestinal symptom and no past history of diarrhea, enema, or antibiotic intake for three weeks before the study. We performed hydrogen breath tests and enteric radionuclide scintigraphy simultaneously every fifteen minutes for six hours after the intake of the test meal composed of an egg sandwich with 1mCi 99mTc sulfur colloid:md lactulose. We compared the results of oro-cecal transit time by scintigraphy with the hydro,;en breath test, in which cecal arrival was defined by various criteria of H2 concentration incri:ment above basal level (eg. 3, 5, 10 ppm and double of baseline).
RESULTS
Oro-cecal transit time by scintigraphy was 87.5+/-20.1 minutes in healthy volunteers and their positive rate of breath hydrogen was 80% in criterion of 10ppm, 66.6% in criterion of 20pprn. Oro-cecal transit time by the hydrogen breath test in which each criterion was defined by 3, 5, 10 ppm and double increase above baseline was 91.8+/-24.6, 106.9+/-32.2, 117.9+/-37.7 and 92.4+/-30.2 minutes respectively. Relationship of oro-cecal transit time by scintigraphy and hydrogen breath test was greatest in criterion of 3ppm increase above basal level in the hydrogen breath test.
CONCLUSIONS
Oro-cecal transit time by the hydrogen breath test was convenient and was also a non-invasive method to evaluate small bowel motility and the most accurate criterion to show cecal arrival was 3ppm increase above baseline compared with the results of radionuclide scintigraphy.