Article Text

Download PDFPDF
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}


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.

  • SIBO, small intestinal bacterial overgrowth
  • IBS, irritable bowel syndrome
  • hydrogen breath tests
  • fructose malabsorption
  • irritable bowel syndrome
  • lactose malabsorption
  • small intestinal bacterial overgrowth

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Conflict of interest: None declared.