title: Follow-up of coeliac disease with the novel one-hour 13C-sorbitol breath test versus the H2-sorbitol breath test.
abstract: BACKGROUND
  We recently developed a (13)C-sorbitol breath test ((13)C-SBT) as an alternative to the H(2)-sorbitol breath test (H(2)-SBT) for coeliac disease. In this study we compared the diagnostic properties of the H(2)-SBT and the (13)C-SBT in follow-up of coeliac disease.
  
  
  METHODS
  Twenty-seven coeliac patients on a gluten-free diet (GFD) performed the breath tests. All had been tested before treatment in the initial study of the (13)C-SBT, in which 39 untreated coeliac patients, 40 patient controls, and 26 healthy volunteers participated. Five gram sorbitol and 100 mg (13)C-sorbitol were dissolved in 250 ml tap water and given orally. H(2), CH(4) and (13)CO(2) were measured in end-expiratory breath samples every 30 min for 4 h. Increased H(2) concentration ≥20 ppm from basal values was used as cut-off for the H(2)-SBT. Sixty minutes values were used as diagnostic index in the (13)C-SBT.
  
  
  RESULTS
  (13)CO(2) levels at 60 min increased in 20/26 treated coeliac patients (77%) after GFD, but were significantly lower than in control groups. Out of 20 patients who had a positive H(2)-SBT before GFD, 12 had a negative H(2)-SBT after GFD. Peak H(2) concentrations were not correlated with (13)C-SBT results.
  
  
  CONCLUSIONS
  The study confirms the sensitivity of a one-hour (13)C-SBT for small intestinal malabsorption. The (13)C-SBT has superior diagnostic properties compared with the H(2)-SBT in follow-up of coeliac disease.
authors.affiliation: Department of Medicine, Lovisenberg Diakonale Hospital, Oslo, Norway. kari.tveito@oslo-universitetssykehus.no
authors.forename: Kari
authors.initials: K
authors.lastname: Tveito
authors.forename: Anne Kristine
authors.initials: AK
authors.lastname: Hetta
authors.forename: Mia
authors.initials: M
authors.lastname: Askedal
authors.forename: Cathrine
authors.initials: C
authors.lastname: Brunborg
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Else Marit
authors.initials: EM
authors.lastname: Løberg
authors.forename: Viggo
authors.initials: V
authors.lastname: Skar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D002446:Celiac Disease / Q000175:diagnosis* / Q000628:therapy; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D006859:Hydrogen; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013012:Sorbitol; D055815:Young Adult
chemical_list: D002247:Carbon Isotopes; D013012:Sorbitol; D006859:Hydrogen