Gut 55:297-303 doi:10.1136/gut.2005.075127
  • Leading article

Use and abuse of hydrogen breath tests

  1. M Simrén,
  2. P-O Stotzer
  1. Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
  1. Correspondence to:
    Dr M Simrén
    Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, S-41345 Göteborg, Sweden; magnus.simren{at}
  • Accepted 6 November 2005
  • Revised 31 October 2005


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.


  • Conflict of interest: None declared.