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HBT

“GOLD –STANDARD”

The hydrogen breath test is now available.

The hydrogen breath test is a test that uses the measurement of hydrogen in the breath to diagnose several conditions that cause gastrointestinal symptoms. In humans, only bacteria - specifically, anaerobic bacteria in the colon - are capable of producing hydrogen. The bacteria produce hydrogen when they are exposed to unabsorbed food, particularly sugars and carbohydrates, but not proteins or fats. Although limited hydrogen is produced from the small amounts of unabsorbed food that normally reach the colon, large amounts of hydrogen may be produced when there is a problem with the digestion or absorption of food in the small intestine, that allows more unabsorbed food to reach the colon.

Large amounts of hydrogen also may be produced when the colon bacteria move back into the small intestine, a condition called bacterial overgrowth of the small bowel. In this latter instance, the bacteria are exposed to unabsorbed food that has not yet had a chance to completely traverse the small intestine to be fully digested and absorbed. Some of the hydrogen produced by the bacteria, whether in the small intestine or the colon, is absorbed into the blood flowing through the wall of the small intestine and colon. The hydrogen-containing blood travels to the lungs where the hydrogen is released and exhaled in the breath where it can be measured.

In this way, a hydrogen breath test is a fairly simple, noninvasive way to check for sugar intolerance or SIBO.

What will the Hydrogen Breath Test detect?

The Hydrogen Breath Test (HBT) is a diagnostic test used to determine the diagnosis of three conditions.

The first is a condition in which dietary sugars are not digested normally. The most common sugar that is poorly digested is lactose, the sugar in milk. Individuals who are unable to properly digest lactose are referred to as lactose intolerant. Testing also may be used to diagnose problems with the digestion of other sugars such as sucrose, fructose and sorbitol.

The second condition for which hydrogen breath testing is used is for diagnosing bacterial overgrowth of the small bowel, a condition in which larger-than-normal numbers of colonic bacteria are present in the small intestine.

The third condition for which hydrogen breath testing is used is for diagnosing rapid passage of food through the small intestine. All three of these conditions may cause abdominal pain, abdominal bloating and distention, flatulence (passing gas in large amounts), and diarrhea

How is hydrogen breath testing performed?

The bacteria in the colon, including the anaerobic bacteria, are able to digest and use sugars and carbohydrates as food. When the anaerobic bacteria digest sugars and carbohydrates, they convert some of the sugars and carbohydrates into gases, most commonly hydrogen. They also may produce and release into the colon other substances, for example, chemicals that cause the colon to secrete water and cause diarrhea.

Some of the hydrogen gas is absorbed by the colon into the blood and is eliminated in the breath where it can be measured. As long as little sugar or carbohydrate reaches the colon, the small amounts of gas and other substances that are produced do not cause a problem. When larger amounts of sugar or carbohydrate reach the colon because they are not digested and absorbed in the small intestine, larger amounts of gas and substances are formed in the colon.

There are ways other than abnormal digestion of dietary sugars by which the bacteria can cause problems. Unlike in the colon, the number of hydrogen-producing, anaerobic bacteria in the small intestine is small. If, however, large

How is hydrogen breath testing performed? Continued…

-numbers of hydrogen-producing bacteria move into the small intestine from the colon, a condition called bacterial -overgrowth of the small bowel, the bacteria may digest the sugars and carbohydrates before the small bowel has had a chance to digest and absorb them and produce large amounts of hydrogen.

Finally, if individuals have abnormally rapid passage of food through the small intestine, there may not be enough time for the small intestine to digest and absorb sugars and carbohydrates. This results in the entry of larger amounts of sugar and carbohydrate into the colon where the bacteria can digest and convert them to gas.

How is hydrogen breath testing performed? Cont…

To diagnose bacterial overgrowth and rapid transit through the small intestine, a sugar that is not digested and absorbed by man, such as lactulose, usually is used for the test. In the case of rapid passage through the small intestine, the sugar passes quickly through the small intestine and into the colon so that hydrogen is found in the breath very soon after ingestion of the sugar. In the case of bacterial overgrowth, production of hydrogen occurs twice during the test. Once as the sugar passes the bacteria in the small intestine and again when the sugar enters the colon.

How is hydrogen breath testing performed?

Prior to hydrogen breath testing, the patient fasts for at least 12 hours. At the start of the test, the patient blows into and fills the collection bag with a breath of air. The concentration of hydrogen is measured in a sample of breath removed from the bag. The patient then ingests a small amount of the test sugar (lactose, sucrose, sorbitol, fructose, lactulose, etc. depending on the purpose of the test). Additional samples of breath are collected and analysed for hydrogen every 15 minutes for up to five hours.

Are there other ways in which hydrogen breath testing can be used?

Antibiotics are used for treating bacterial overgrowth of the small bowel; however, any one antibiotic may be effective at eliminating the overgrowing bacteria only 50%-60% of the time. Therefore, if symptoms do not disappear in an individual following treatment with antibiotics, it may be useful to repeat the breath test to determine if the antibiotics have eliminated the bacteria. If not, a different antibiotic or non-antibiotic treatment can be tried.

The principle of Hydrogen Breath Test

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Benefits of testing

Hydrogen Breath Test is a simple, non-invasive and advanced accurate diagnostic technology for detecting cause gastrointestinal symptoms.

Accurate

Comfortable

• Non-invasive, no endoscopic tube insertion, well tolerated by patients

Convenient

• Near-patient testing, analysis made on site, minimal inconvenience for patient

Simple

• Easy operation, no special handling required

Sample required

Breath

Hydrogen Breath test (HBT) Product performance

Hydrogen Breath Test

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Contact information

If further information regarding testing is required, or you

need to discuss a patient, please contact local

Scientific Diagnostic Consultant

A: Westend Clinic Extension

7 Baines Avenue, Harare

C: 0774 383 328

E: info@ubchealthcare.co.zw

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