The Hydrogen Breath Test and its setting as an efficient, non-invasive method for assessing digestive-absorptive function

In the past, it was believed that the lungs were organs only responsible for breathing and, therefore, there was the concept that only Oxygen (O₂) and Carbon Dioxide (CO₂) could be measured in the exhaled air. Currently, however, it is known that the exhaled air from the lungs contains more than 2000 different substances, and that the lungs have an additional function, the excretion of volatile substances, therefore the lungs are considered as “excretory organs” of dissolved gases in blood. One of these numerous volatile substances excreted by the lungs is Hydrogen (H₂), which can be easily measured with manual breathing test equipment.

The healthy human being in fasting and at rest does not eliminate H₂ because his metabolism does not produce this gas, it is only generated during anaerobic metabolism. As the resting human organism does not have anaerobic metabolism, the H₂ produced and excreted by the lungs originates from the action of anaerobic bacteria, which are natural colonizers of undigested substrates on the large intestine. Thus, under normal conditions, the H₂ measured in exhaled air refers to the amount of metabolic activity of anaerobic bacteria present in the ileum and the large intestine. However, in pathological situations, for example, in the syndrome of “Bacterial Overgrowth in the Small Intestine“, the concentration of anaerobic bacteria becomes predominant in the small intestine and can reach values ​​over 10⁴ colonies/ml. Anaerobic bacteria have the ability to metabolize carbohydrates as a source of energy for their nutrition, which, due to this chemical fermentation reaction, are “broken” resulting in the formation of short-chain fatty acids, CO₂ and H₂. A significant portion of the CO₂ that remains in the intestinal lumen is responsible for the flatulence, while the short-chain fatty acids attract, by osmotic effect, water into the intestinal lumen, causing diarrhea. The H₂ produced permeates the gastrointestinal wall, enters the systemic blood circulation, from where it is transported to the lungs and is finally eliminated by breathing. The concentration of expired H₂ can therefore be easily measured in parts per million (ppm) using a non-invasive hand-held device. The H₂ concentration measured at exhaled breath is always in function of the mass of bacteria and the bacterial metabolic activity in the digestive tract. The moment when the H₂ concentration in the exhaled breath rises during the breath test provides an indication in which region of the he fermentation took place.

Types of Hydrogen Breath Tests

Any carbohydrate, such as monosaccharides, Glucose, Fructose and Galactose, disaccharides, Sucrose, Maltose and Lactose, and even polysaccharides, alcohol-sugars, and the synthetic disaccharide Lactulose, non-absorbable (Galactose-Fructose), can be used for the performance of the Hydrogen Breath Test. The types of sugar most used for the test are: Glucose, Lactose, Fructose and Lactulose.

The main indications for performing the Hydrogen Breath Test are:

• Malabsorption syndrome;
• Irritable bowel syndrome;
• Fructose intolerance;
• Lactose intolerance;
• Investigation of meteorism and flatulence;
• Monitoring of celiac disease;
• Inflammatory bowel disease;
• Lactase deficiency;
• Bacterial overgrowth in the small intestine.

At Renylab you will find the complete line of substrates for carrying out Hydrogen Breath Test.

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Source: www.igastroped.com.br