LEADING ARTICLE

Use and abuse of hydrogen breath tests

M Simrén, P-O Stotzer

Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden

Correspondence to:
Correspondence to:
Dr M Simrén
Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, S-41345 Göteborg, Sweden; magnus.simren{at}medicine.gu.se

Hydrogen breath tests are widely used to explore the pathophysiology of functional gastrointestinal disorders. Small intestinal bacterial overgrowth and carbohydrate malabsorption are disorders detected by these tests that have been proposed to be of great importance for symptoms in, for instance, irritable bowel syndrome. However, conclusions drawn from these studies are highly controversial and divergent results exist. There is also an extensive use of these tests in clinical practice with difficulties regarding interpretation of the tests and sometimes erroneous conclusions. The limitations and pitfalls of these tests will be reviewed in this article, and hopefully the occasional abuse of these tests can be turned into proper clinical and scientific use instead in the future.

Keywords: hydrogen breath tests; fructose malabsorption; irritable bowel syndrome; lactose malabsorption; small intestinal bacterial overgrowth

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Quigley, E. M.M. (2009). Review: Do patients with functional gastrointestinal disorders have an altered gut flora?. Therapeutic Advances in Gastroenterology 2: s23-s30 [Abstract]  
• Gaskin, D. J., Ilich, J. Z. (2009). Lactose Maldigestion Revisited: Diagnosis, Prevalence in Ethnic Minorities, and Dietary Recommendations to Overcome It. AMERICAN JOURNAL OF LIFESTYLE MEDICINE 3: 212-218 [Abstract]  
• Wenzel, J. J., Rossmann, H., Kullmer, U., Oberman, B., Mengel, E., Lackner, K. J., Lotz, J. (2009). Chronic Diarrhea in a 5-Year-Old Girl: Pitfall in Routine Laboratory Testing with Potentially Severe Consequences. Clin. Chem. 55: 1026-1030 [Full Text]  
• Shu, K.-H., Chang, C.-S., Chuang, Y.-W., Chen, C.-H., Cheng, C.-H., Wu, M.-J., Yu, T.-M. (2009). Intestinal bacterial overgrowth in CAPD patients with hypokalaemia. Nephrol Dial Transplant 24: 1289-1292 [Abstract] [Full Text]  
• Simren, M, Posserud, I, Stotzer, P-O, Bjornsson, E S, Abrahamsson, H (2008). Authors' reply. Gut 57: 1335-1335 [Full Text]  
• Vanner, S (2008). The small intestinal bacterial overgrowth. Irritable bowel syndrome hypothesis: implications for treatment. Gut 57: 1315-1321 [Full Text]  
• Posserud, I., Stotzer, P.-O., Bjornsson, E. S, Abrahamsson, H., Simren, M. (2007). Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut 56: 802-808 [Abstract] [Full Text]