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Relationships Among the Lactulose Breath Test, Intestinal Gas Volume, and Gastrointestinal Symptoms in Patients with Irritable Bowel Syndrome

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Abstract

Background and Aims

Irritable bowel syndrome (IBS) patients frequently complain of gas-related symptoms, and the lactulose breath test (LBT) is a test that assesses the amount of fermented gas generated by bacteria in the bowel. We aimed to assess the relationship among intestinal gas volume, LBT result, and gastrointestinal symptom score in healthy control and functional bowel disorder (FBD) subjects.

Method

In 84 IBS subjects, 24 FBD subjects other than IBS, and 25 healthy controls, a symptom questionnaire that enquired about seven main symptoms, plain abdominal radiography and a LBT were checked on the same day. The intestinal gas volume was calculated as the gas volume score (GVS) with a digitalized image of plain supine abdominal radiographs.

Results

The GVS was greater in the LBT (+) group compared to the LBT (−) group (P = 0.02). The GVS was greater in the FBD and IBS groups than in the control group (P < 0.01). The GVS showed low but positive correlations with the severity and frequency of bloating, flatulence, abdominal pain, constipation, and tenesmus (P < 0.05). The severity of flatulence (P = 0.02) and the frequency of bloating (P = 0.02) in the LBT (+) group were significantly higher than those in the LBT (−) group.

Conclusions

Subjects with positive LBT had more gas-related symptoms and greater gas volume scores. Gas-related symptoms, positive LBT and increased GVS were significantly associated to each other. These findings can broaden the understanding of the pathophysiologic mechanisms of gas-related symptoms in IBS.

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Conflict of interest

No financial support. The authors have no conflict of interests to declare.

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Authors and Affiliations

  1. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Gangnam-Gu Seoul, 135-720, Korea

    Young Hoon Youn, Jung Soo Park, Jae Hoon Jahng, Hyun Chul Lim, Jie-Hyun Kim, Hyojin Park & Sang In Lee

  2. GI Motility Program, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Mark Pimentel

Authors
  1. Young Hoon Youn
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  2. Jung Soo Park
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  3. Jae Hoon Jahng
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  4. Hyun Chul Lim
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  5. Jie-Hyun Kim
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  6. Mark Pimentel
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  7. Hyojin Park
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  8. Sang In Lee
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Corresponding author

Correspondence to Hyojin Park.

Additional information

These data were presented in preliminary abstract form at the UEGW 2010, Barcelona, Spain.

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Youn, Y.H., Park, J.S., Jahng, J.H. et al. Relationships Among the Lactulose Breath Test, Intestinal Gas Volume, and Gastrointestinal Symptoms in Patients with Irritable Bowel Syndrome. Dig Dis Sci 56, 2059–2066 (2011). https://doi.org/10.1007/s10620-011-1569-2

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  • DOI: https://doi.org/10.1007/s10620-011-1569-2

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