Korean J Gastroenterol.  2020 Jan;75(1):23-28. 10.4166/kjg.2020.75.1.23.

Influencing Factors on Lactulose Breath Test Results

• Kim JW
• Park SY
• Chung JO
• Cho HA
• Kim DH
• Yoon JH
• Park CH
• Kim HS
• Choi SK
• Rew JS

• KMID: 2471136
• DOI: http://doi.org/10.4166/kjg.2020.75.1.23

Abstract

BACKGROUND/AIMS
This study aimed to identify the demographic and clinical factors associated with positive breath-test results and to assess the relationship between hydrogen and methane production in patients with suspected irritable bowel syndrome (IBS).
METHODS
The demographic and clinical factors of 268 patients with suspected IBS, who had undergone a lactulose breath test, were analyzed.
RESULTS
Of 268 patients included in this study, 143 (53.4%) were females. The median age and BMI of the patients was 58.0 years (range, 18.0-80.0 years) and 22.5 kg/m² (range, 14.4-34.3 kg/m²), respectively. A weak positive correlation was observed between the BMI and baseline hydrogen level (rho=0.134, p=0.031). Women were significantly more likely to show a ≥20 ppm increase in hydrogen within 90 min (early hydrogen increase, p=0.049), a ≥10 ppm increase in methane within 90 min (early methane increase, p=0.001), and a ≥10 ppm increase in methane between 90 min and 180 min (late methane increase, p=0.002) compared to men. The baseline hydrogen level was related to the baseline methane level (rho=0.592, p<0.001) and the maximal hydrogen level within 90 min was related to maximal methane level within 90 min (rho=0.721, p<0.001). Patients with an early hydrogen increase (43.8%) were more likely to show a positive result for an early methane increase compared to patients without an early increase in hydrogen (0%, p<0.001).
CONCLUSIONS
Women were associated with high rates of positive lactulose breath-test results. In addition, methane production was correlated with hydrogen production.

Keyword

Lactulose; Breath tests; Irritable bowel syndrome; Difference, sex

MeSH Terms

Breath Tests*
Female
Humans
Hydrogen
Irritable Bowel Syndrome
Lactulose*
Male
Methane
Sex Characteristics
Hydrogen
Lactulose
Methane

Figure

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  Fig. 1 Association between the body mass index (BMI) and baseline hydrogen level. A weak positive correlation was observed between the BMI and baseline hydrogen level (rho=0.134, p=0.031).

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  Fig. 2 Associations between hydrogen production and methane production. (A) Baseline hydrogen level was related to the baseline methane level (rho=0.592, p<0.001). (B) A maximal hydrogen level within 90 min was related to the maximal methane level within 90 min (rho=0.721, p<0.001).

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