Lactose Intolerance Breath Test

What is Hydrogen Breath Testing?

Hydrogen breath testing is used to diagnose three primary conditions. First, hydrogen breath testing detects sugars like lactose that are not properly digested and metabolized. Secondly, hydrogen breath testing detects sugars like fructose that are not absorbed in sufficient levels. Thirdly, hydrogen breath testing is used to diagnose bacterial overgrowth of the small bowel.

What is the principle of the Lactose Intolerance Breath Test?

The hydrogen breath test for lactose intolerance provides clinical information about the digestion of lactose, the predominant sugar in milk and diary products. Lactose intolerance refers to the abnormal processing of lactose.

Hydrogen and methane gas are produced in the body from intestinal bacteria. Bacteria ferment sugars such as lactose to hydrogen and/or methane gas. Hydrogen and methane are absorbed by the intestinal mucosa, enter the vasculature, and get transported to the lungs. A change in the level of hydrogen and/or methane gas above 20 parts per million is diagnostic for lactose intolerance. The majority, but not all malabsorbers produce hydrogen gas. Approximately 15% of patients are methane producers rather than hydrogen producers. These patients will only be properly diagnosed by measuring methane levels. As a result, each breath specimen is measured by Metabolic Solutions for hydrogen and methane.

What causes Lactose Intolerance?

Lactose intolerance is the inability to digest significant amounts of lactose. In lactose intolerance, a patient has a deficiency in lactase, the enzyme that breaks down lactose. Normally, lactose is broken down in the small intestine by lactase and very little lactose reaches the large intestine. In lactose intolerance (lactase deficiency), the ingested lactose is not metabolized in the small intestine and reaches the colon where colonic bacteria ferment the sugar and produce a large amount of hydrogen and methane gas that appears in the breath. Other causes of lactose intolerance can include celiac sprue, gastroenteritis, or bowel surgery. Temporary lactase deficiency can result from viral and bacterial infections.

Why should I test for Lactose Intolerance?

Studies have shown that nearly 50% of people who self-report milk intolerance are not maldigesters. Instead they suffer from a functional bowel disorder such as irritable bowel syndrome (IBS), recurrent abdominal pain (RAP) in children or some other gastrointestinal complication. Recurrent abdominal pain (RAP) occurs in 10 to 15% of school-age children. In self-reported milk intolerants, it has been found that there is a significant, unnecessary reduction in milk consumption and insufficient dietary calcium intake.

The diagnosis of lactose intolerance has relied on an interview process coupled with removing milk (and milk products) from the diet, laboratory tests and jejunal biopsy. The interview process is overly simplistic and quite imprecise. First, nearly 50% of people who self-report milk intolerance are normal digesters of lactose and secondly, 70% of the people with lactase-deficiency (although symptomatic) fail to correlate the broad gastrointestinal symptoms of this disease to the intake of lactose.

What types of patients have Lactose Intolerance?

Lactose intolerance affects an estimated 50 million Americans. This condition is more common in Asian, African, African-American, Native American, and Mediterranean populations than it is among northern and western Europeans.

What age does Lactose Intolerance occur?

The age of onset of lactose intolerance is variable. At birth, humans have abundant lactase activity in the small intestine but in most ethnic groups this activity decreases significantly during childhood between ages 3 to 5. In Caucasians, it usually starts to affect children older than age 5. In African-Americans, lactose intolerance often occurs as early as age 2. Lactose intolerance is very common in adults, is not dangerous but causes very unpleasant dyspeptic symptoms. Approximately 30 million American adults have some amount of lactose intolerance by age 20.

What are the symptoms of Lactose Intolerance?

• Abdominal cramps
• Abdominal bloating
• Diarrhea
• Gas (flatulence)
• Nausea

How do I treat Lactose Intolerance?

Avoid foods with lactose. Patients should take lactase supplements or diary treated with lactase. Consumption of soymilk should be recommended instead of milk from cows.