Influence of colectomy on hydrogen excretion in breath.
BACKGROUND
Hydrogen breath test is the most commonly used method to analyze carbohydrate absorption and diagnose carbohydrate malabsorption. The result of the H(2) breath test is influenced by different factors, which are mostly related to quantitative or qualitative aspects of colonic flora. A scarcely studied variable is the effect of colonic anatomical integrity on H(2) excretion in breath.


OBJECTIVE
The present study aims to determine whether loss of colonic integrity reduces H(2) excretion capacity after an oral load of an unabsorbable carbohydrate.


METHODS
An observational study was conducted in three patient groups: controls with preserved colon, patients with partial colectomy, and patients with complete colectomy and ileostomy. H(2) concentration in breath was measured by gas chromatography every 10 min for 3 h after oral lactulose administration.


RESULTS
Twenty-two patients with partial colectomy, 18 controls with preserved colon, and seven patients with ileostomy were included. H(2) excretion after lactulose did not differ between patients with partial colectomy and controls (basal excretion = 8.5 vs 4 ppm; delta increase = 50.0 vs 47.5 ppm; area under the curve = 4,480.0 vs 4,710.5 ppm/min). In contrast, H(2) excretion was significantly lower in the ileostomy group.


CONCLUSIONS
Partial colectomy does not influence the capacity for H(2) excretion after oral unabsorbable carbohydrate administration.
Casellas
Francesc
F
Digestive System Research Unit, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona 08035, Spain. fcasellas@vhebron.net
Torrejón
A
A
Vilaseca
J
J
Aparici
A
A
Casaus
M
M
Rodríguez
P
P
Guarner
F
F
D000328:Adult; D000368:Aged; D001944:Breath Tests; D050260:Carbohydrate Metabolism; D002849:Chromatography, Gas; D003082:Colectomy / Q000009:adverse effects*; D045853:Exhalation / Q000502:physiology; D005260:Female; D006801:Humans; D006859:Hydrogen / Q000032:analysis* / Q000378:metabolism; D007408:Intestinal Absorption; D007792:Lactulose / Q000008:administration & dosage / Q000378:metabolism; D008286:Malabsorption Syndromes / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged
D007792:Lactulose; D006859:Hydrogen