Relationships among the lactulose breath test, intestinal gas volume, and gastrointestinal symptoms in patients with irritable bowel syndrome.
OBJECTIVE
Irritable bowel syndrome (IBS) patients frequently complain of gas-related symptoms, and the lactulose breath test (LBT) is a test that assesses the amount of fermented gas generated by bacteria in the bowel. We aimed to assess the relationship among intestinal gas volume, LBT result, and gastrointestinal symptom score in healthy control and functional bowel disorder (FBD) subjects.


METHODS
In 84 IBS subjects, 24 FBD subjects other than IBS, and 25 healthy controls, a symptom questionnaire that enquired about seven main symptoms, plain abdominal radiography and a LBT were checked on the same day. The intestinal gas volume was calculated as the gas volume score (GVS) with a digitalized image of plain supine abdominal radiographs.


RESULTS
The GVS was greater in the LBT (+) group compared to the LBT (-) group (P = 0.02). The GVS was greater in the FBD and IBS groups than in the control group (P < 0.01). The GVS showed low but positive correlations with the severity and frequency of bloating, flatulence, abdominal pain, constipation, and tenesmus (P < 0.05). The severity of flatulence (P = 0.02) and the frequency of bloating (P = 0.02) in the LBT (+) group were significantly higher than those in the LBT (-) group.


CONCLUSIONS
Subjects with positive LBT had more gas-related symptoms and greater gas volume scores. Gas-related symptoms, positive LBT and increased GVS were significantly associated to each other. These findings can broaden the understanding of the pathophysiologic mechanisms of gas-related symptoms in IBS.
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Gangnam-Gu Seoul, 135-720, Korea.
Young Hoon
YH
Youn
Jung Soo
JS
Park
Jae Hoon
JH
Jahng
Hyun Chul
HC
Lim
Jie-Hyun
JH
Kim
Mark
M
Pimentel
Hyojin
H
Park
Sang In
SI
Lee
D000328:Adult; D001944:Breath Tests; D003248:Constipation / Q000503:physiopathology; D003967:Diarrhea / Q000503:physiopathology; D005260:Female; D005414:Flatulence / Q000503:physiopathology*; D006801:Humans; D007422:Intestines / Q000503:physiopathology; D043183:Irritable Bowel Syndrome / Q000503:physiopathology*; D007792:Lactulose; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011860:Radiography, Abdominal; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D007792:Lactulose
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