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Digestive Diseases and Sciences

, Volume 47, Issue 3, pp 489–494 | Cite as

The Glucose Breath Test: A Diagnostic Test for Small Bowel Stricture(s) in Crohn's Disease

  • Daniel Mishkin
  • Francis M. Boston
  • David Blank
  • Morty Yalovsky
  • Seymour Mishkin
Article

Abstract

The aim of this study was to determine whether an indirect noninvasive indicator of proximal bacterial overgrowth, the glucose breath test, was of diagnostic value in inflammatory bowel disease. Twenty four of 71 Crohn's disease patients tested had a positive glucose breath test. No statistical conclusions could be drawn between the Crohn's disease activity index and glucose breath test status. Of patients with radiologic evidence of small bowel stricture(s), 96.0% had a positive glucose breath test, while only one of 46 negative glucose breath test patients had a stricture. The positive and negative predictive values for a positive glucose breath test as an indicator of stricture formation were 96.0% and 97.8%, respectively. This correlation was not altered in Crohn's disease patients with fistulae or status postresection of the terminal ileum. The data in ulcerative colitis were nondiagnostic. In conclusion, the glucose breath test appears to be an accurate noninvasive inexpensive diagnostic test for small bowel stricture(s) and secondary bacterial overgrowth in Crohn's disease.

glucose breath test bacterial overgrowth small bowel stricture Crohn's disease 

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REFERENCES

  1. 1.
    Binion DG, Fiocchi C: Immune modulation-is the environment important? In Trends in Inflammatory Bowel Disease Therapy. RS McLeod, K Martin, LR Sutherland, JL Wallace, CN Williams (eds). Boston, Kluwer Academic Publishers, 1996, pp 39–48Google Scholar
  2. 2.
    Sartor RB: Insights into the pathogenesis of inflammatory bowel diseases provided by new rodent models of spontaneous colitis. Inflamm Bowel Dis 1:64–75, 1995Google Scholar
  3. 3.
    Hanauer SB: Medical therapy for Crohn's disease. Curr Opin Gastroenterol 15:308–314, 1999Google Scholar
  4. 4.
    Mishkin B, Yalovsky M, Mishkin S: Increased prevalence of lactose malabsorption in Crohn's disease patients at low risk for lactose malabsorption based on ethnic origin. Am J Gastroentrol 92(7):1148–1153, 1997Google Scholar
  5. 5.
    King CE, Toskes PP: The use of breath tests in the study of malabsorption. Clin Gastroenterol 12:591–610, 1983Google Scholar
  6. 6.
    Toskes PP, Kumar A: Enteric bacterial flora and bacterial overgrowth syndrome. In Gastrointestinal and Liver Disease, 6th ed. NH Sleisenger, GS Fordtran (eds). Philadelphia, WB Saunders, 1998, pp 1523–1534Google Scholar
  7. 7.
    Sellin JH, Hart R: Glucose malabsorbtion associated with rapid intestinal transit. Am J Gastroenterol 87:584–589, 1992Google Scholar
  8. 8.
    Stenson WF, MacDermott RP: Inflammatory bowel disease. In Textbook of Gastroenterology. JP Yamada (ed). Philadelphia, JB Lippincott, 1991, pp 1588–1645Google Scholar
  9. 9.
    Best WR, Becktel JM, Singleton JW: Development of a Crohn's disease activity index: National cooperative Crohn's disease study. Gastroenterol 70:439–444, 1976Google Scholar
  10. 10.
    Truelove SC, Witts LJ: Cortisone in ulcerative colitis: Final report on a therapeutic trial. BMJ 2:1041–1048, 1955Google Scholar
  11. 11.
    Mishkin SR, Sablauskas L, Mishkin S: Fructose and/or sorbitol malabsorption in a subgroup of lactose intolerant patients. Can J Gastroenterol 8:389–393, 1994Google Scholar
  12. 12.
    Kerlin P, Wong L: Breath hydrogen testing in bacterial overgrowth of the small intestine. Gastroenterol 95:982–988, 1988Google Scholar
  13. 13.
    Rhodes JM, Middleton P, Jewell DP: The lactulose hydrogen breath test as a diagnostic test for small-bowel bacterial overgrowth. Scand J Gastroenterol 14:333–336, 1979Google Scholar
  14. 14.
    King CE, Toskes PP: Comparison of the 1-gram (14C)xylose, 10-gram lactulose-H2, and 80-gram glucose-H2 breath tests in patients with bacterial overgrowth. Gastroenterology 91:1447–1451, 1986Google Scholar
  15. 15.
    Bernstein CN, Boult IF, Greenberg HM, Van der Putten W, Duffy G, Grahame GR: A prospective comparison between small bowel enteroclysis and small bowel follow-through in Crohn's disease. Gastroenterology 113:390–398, 1997Google Scholar
  16. 16.
    Simon GL, Gorbach SL: The human intestinal microflora. Dig Dis Sci 31(suppl 9): 147S–162S, 1986Google Scholar
  17. 17.
    Donaldson, RM Jr: Malabsorption of 60Co-labelled cyanocobalamin in rats with intestinal diverticula. 1. Evaluation of possible mechanisms. Gastroenterology 43(B):271–281, 1962Google Scholar
  18. 18.
    Gianella RA, Rout WR, Toskes PP: Jejunal brush border injury and impaired sugar and amino acid uptake in the blind loop syndrome. Gastroenterology 67:965–974, 1974Google Scholar
  19. 19.
    Varcoe R, Holliday D, Tavill A: Utilization of urea nitrogen for albumin synthesis in the stagnant loop syndrome. Gut 15:898–902, 1974Google Scholar
  20. 20.
    King CE, Toskes PP: Protein-losing enteropathy in the human and experimental blind loop syndrome. Gastroenterology 80:504–509, 1981Google Scholar
  21. 21.
    Toskes PP, Gianella RA, Jervis HR, Rout WR, Takeuchi A: Small intestinal mucosal injury in the experimental blind loop syndrome. Gastroenterology 68:1193–1203, 1975Google Scholar
  22. 22.
    Justus PG, Fernandez A, Martin JL, King CE, Toskes PP, Mathias JR: Altered myoelectric activity in the experimental blind loop syndrome. J Clin Invest 72:1064–1071, 1983Google Scholar
  23. 23.
    Belliveau P, Trudel J, Vasilevsky C, Stein B, Gordon PH: Ileoanal anastomosis with reservoirs: Complications and long-term results. Can J Surg 42:345–352, 1999Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Daniel Mishkin
    • 1
  • Francis M. Boston
    • 1
  • David Blank
    • 1
  • Morty Yalovsky
    • 1
  • Seymour Mishkin
    • 1
  1. 1.Departments of Medicine, Clinical Biochemistry, Radiology and ManagementMcGill UniversityMontrealCanada

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