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Influence of Previously Ingested Wheat on Fasting Breath Hydrogen in Celiac Patients

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Abstract

The excretion of hydrogen in breath commonly persists, despite an overnight fast. Although the elevation of hydrogen concentration above the fasting value after the administration of a test sugar is evidence of malabsorption, the level of the fasting value itself in untreated celiac patients is unknown. Therefore, we studied the fasting breath hydrogen (FBH2) concentration in 40 healthy controls, 35 subjects with functional bowel disorders, and 30 patients of untreated celiac disease with and without bread or wheat diet one day before the test. The fasting level of hydrogen concentration in untreated celiac patients (28.7 ± 19.5 ppm) was significantly higher than those in healthy volunteers (9.5 ± 3.4 ppm) and subjects with functional bowel disorders (10.6 ± 4.5 ppm). The percentage of patients with elevated H2 fasting levels in untreated celiac disease (82.5%) was significantly higher than that in healthy controls (10%) and subjects with functional bowel disorders (17.1%). In 30 celiac patients, studied with and without wheat-free diet one day before the test, the fasting hydrogen levels decreased from 28.7 ± 19.5 ppm to 10.6 ± 3.5 ppm, and becoming normal in all patients of celiac disease. Our results show that the patients of untreated celiac disease should be instructed not to eat things made up of wheat one day before hydrogen breath testing so that the normal fasting hydrogen concentration can be obtained and false-negative hydrogen breath test results can be avoided.

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References

  1. Green PH, Jabri B. Celiac disease. Lancet. 2003;362:383–391.

    Article  PubMed  CAS  Google Scholar 

  2. Maki M, Mustalahti K, Kokkonen J, et al. Prevalence of celiac disease among children in Finland. N Engl J Med. 2003;348:2517–2524. doi:10.1056/NEJMoa021687.

    Article  PubMed  Google Scholar 

  3. Corazza GR, Villanacci V. Celiac disease: some considerations on the histological diagnosis. J Clin Pathol. 2005;58:573–574. doi:10.1136/jcp.2004.023978.

    Article  PubMed  CAS  Google Scholar 

  4. West J, Lloyd CA, Hill PG, et al. IgA-antitissue-transglutaminase: validation of a commercial assay for diagnosing celiac disease. Clin Lab (Zaragoza). 2002;48:241–246.

    CAS  Google Scholar 

  5. Di Stefano M, Miceli E, Missanelli A, Malservisi S, Strocchi A, Corazza GR. Fermentation of endogenous substrates is responsible for increased fasting breath hydrogen levels in celiac disease. J Lab Clin Med. 2004;143(3):163–168. doi:10.1016/j.lab.2003.11.006.

    Article  PubMed  CAS  Google Scholar 

  6. Almeida PL, Gandolfi L, Modelli IC, Martins RD, Almeida RC, Pratesi R. Prevalence of celiac disease among first-degree relatives of Brazilian celiac patients. Arq Gastroenterol. 2008;45(1):69–72. doi:10.1590/S0004-28032008000100013.

    Article  PubMed  Google Scholar 

  7. Kerlin P, Wong L. Breath hydrogen testing in bacterial overgrowth of the small intestine. Gastroenterology. 1988;95(4):982–988.

    PubMed  CAS  Google Scholar 

  8. Urita Y, Sugimoto M, Hike K, et al. High incidence of fermentation in the digestive tract in patients with reflux oesophagitis. Eur J Gastroenterol Hepatol. 2006;18(5):531–535. doi:10.1097/00042737-200605000-00013.

    Article  PubMed  Google Scholar 

  9. Riordan SM, McIver CJ, Bolin TD, Duncombe VM. Fasting breath hydrogen concentrations in gastric and small-intestinal bacterial overgrowth. Scand J Gastroenterol. 1995;30(3):252–257. doi:10.3109/00365529509093273.

    Article  PubMed  CAS  Google Scholar 

  10. Levitt MD. Production and excretion of hydrogen gas in man. N Engl J Med. 1969;17; 281(3):122–127.

    Google Scholar 

  11. Levitt MD, Donaldson RM. Use of respiratory hydrogen (H2) excretion to detect carbohydrate malabsorption. J Lab Clin Med. 1970;75(6):937–945.

    PubMed  CAS  Google Scholar 

  12. Bond JH, Levitt MD. Use of pulmonary hydrogen (H2) measurements to quantitate carbohydrate absorption. Study of partially gastrectomized patients. J Clin Invest. 1972;51(5):1219–1225. doi:10.1172/JCI106916.

    Article  PubMed  CAS  Google Scholar 

  13. Kotler DP, Holt PR, Rosensweig NS. Modification of the breath hydrogen test: increased sensitivity for the detection of carbohydrate malabsorption. J Lab Clin Med. 1982;100(5):798–805.

    PubMed  CAS  Google Scholar 

  14. Perman JA, Modler S, Barr RG, Rosenthal P. Fasting breath hydrogen concentration: normal values and clinical application. Gastroenterology. 1984;87(6):1358–1363.

    PubMed  CAS  Google Scholar 

  15. Corazza GR, Villanacci V, Zambelli C, et al. Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease. Clin Gastroenterol Hepatol. 2007;5:838–843. doi:10.1016/j.cgh.2007.03.019.

    Article  PubMed  Google Scholar 

  16. Gilat T, Ben Hur H, Gelman-Malachi E, Terdiman R, Peled Y. Alterations of the colonic flora and their effect on the hydrogen breath test. Gut. 1978;19(7):602–605. doi:10.1136/gut.19.7.602.

    Article  PubMed  CAS  Google Scholar 

  17. Thompson DG, Binfield P, De Belder A, O’Brien J, Warren S, Wilson M. Extra intestinal influences on exhaled breath hydrogen measurements during the investigation of gastrointestinal disease. Gut. 1985;26(12):1349–1352. doi:10.1136/gut.26.12.1349.

    Article  PubMed  CAS  Google Scholar 

  18. Perman JA, Modler S, Engel RR, Heldt G. Effect of ventilation on breath hydrogen measurements. J Lab Clin Med. 1985;105(4):436–439.

    PubMed  CAS  Google Scholar 

  19. Brummer RJ, Armbrecht U, Bosaeus I, Dotevall G, Stockbruegger RW. The hydrogen (H2) breath test. Sampling methods and the influence of dietary fiber on fasting level. Scand J Gastroenterol. 1985;20(8):1007–1013. doi:10.3109/00365528509088863.

    Article  PubMed  CAS  Google Scholar 

  20. Solomons NW, Hamilton LH, Christman NT, Rothman D. Evaluation of a rapid breath hydrogen analyzer for clinical studies of carbohydrate absorption. Dig Dis Sci. 1983;28(5):397–404. doi:10.1007/BF02430527.

    Article  PubMed  CAS  Google Scholar 

  21. Metz G, Gassull MA, Drasar BS, Jenkins DJ, Blendis LM. Breath-hydrogen test for small-intestinal bacterial colonisation. Lancet. 1976;1(7961):668–669. doi:10.1016/S0140-6736(76)92779-3.

    Article  PubMed  CAS  Google Scholar 

  22. Bond JH, Levitt MD, Prentiss R. Investigation of small bowel transit time in man utilizing pulmonary hydrogen (H2) measurements. J Lab Clin Med. 1975;85(4):546–555.

    PubMed  CAS  Google Scholar 

  23. Gillon J, Tadesse K, Logan RF, Holt S, Sircus W. Breath hydrogen in pneumatosis cystoides intestinalis. Gut. 1979;20(11):1008–1011. doi:10.1136/gut.20.11.1008.

    Article  PubMed  CAS  Google Scholar 

  24. Bali A, Stableforth DE, Asquith P. Prolonged small-intestinal transit time in cystic fibrosis. Br Med J (Clin Res Ed). 1983;287(6398):1011–1013.

    Article  CAS  Google Scholar 

  25. Corazza GR, Strocchi A, Gasbarrini G. Fasting breath hydrogen in celiac disease. Gastroenterology. 1987;93(1):53–58.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, House #137, Sector 15-A, Chandigarh, 160015, India

    S. V. Rana, S. Sharma, S. K. Sinha, J. Kaur, K. K. Prasad & K. Singh

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  1. S. V. Rana
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  2. S. Sharma
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  3. S. K. Sinha
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  4. J. Kaur
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  5. K. K. Prasad
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  6. K. Singh
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Correspondence to S. V. Rana.

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Rana, S.V., Sharma, S., Sinha, S.K. et al. Influence of Previously Ingested Wheat on Fasting Breath Hydrogen in Celiac Patients. Dig Dis Sci 54, 1276–1279 (2009). https://doi.org/10.1007/s10620-008-0496-3

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  • DOI: https://doi.org/10.1007/s10620-008-0496-3

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