J Korean Med Sci.  2013 Jun;28(6):901-907. 10.3346/jkms.2013.28.6.901.

Association between Symptoms of Irritable Bowel Syndrome and Methane and Hydrogen on Lactulose Breath Test

• Lee KN
• Lee OY
• Koh DH
• Sohn W
• Lee SP
• Jun DW
• Lee HL
• Yoon BC
• Choi HS
• Hahm JS

• KMID: 2158039
• DOI: http://doi.org/10.3346/jkms.2013.28.6.901

Abstract

Whether hydrogen and methane gas produced during lactulose breath test (LBT) are associated with symptoms of irritable bowel syndrome (IBS) is not determined. We aimed to investigate whether hydrogen and methane on LBT are associated with IBS symptoms. Sixty-eight IBS patients meeting the Rome III criteria for IBS, and 55 healthy controls, underwent LBT. The IBS subjects recorded their customary gastrointestinal symptoms on a questionnaire using visual analogue scales. LBT positivity was defined to be above 20 ppm rise of hydrogen or 10 ppm rise of methane within 90 min. Gas amounts produced during LBT were determined by calculating area under the curve of hydrogen and methane excretion. Symptom severity scores were not different between the LBT (+) IBS and LBT (-) IBS subjects and also between methane producers and non-methane producers. Gas amounts produced during LBT were not associated with IBS symptoms, except a weak correlation between total gas amounts and a few IBS symptoms such as bloating (r = 0.324, P = 0.039), flatulence (r = 0.314, P = 0.046) and abdominal pain (r = 0.364, P = 0.018) only in LBT (+) IBS. In conclusion, hydrogen and methane gas on LBT are not useful for predicting the customary symptoms and subtypes of IBS.

Keyword

Irritable Bowel Syndrome; Lactulose Breath Test; Intestinal Gas; Hydrogen; Methane

MeSH Terms

Abdominal Pain/etiology
Adult
Area Under Curve
Breath Tests
Female
Flatulence/etiology
Gases/analysis
Humans
Hydrogen/*analysis
Irritable Bowel Syndrome/*diagnosis
Lactulose/*metabolism
Male
Methane/*analysis
Middle Aged
ROC Curve
Risk Factors
Gases
Lactulose
Hydrogen
Methane

Figure

• 

  Fig. 1 Schematic drawing of lactulose breath tests indicating positivity for hydrogen.

• 

  Fig. 2 (A) The comparison of symptom severity scores in lower gastrointestinal symptoms between IBS patients with LBT (+) and LBT (-) for hydrogen. There were no significant differences in the severity scores of IBS symptoms between the groups. (B) The comparison of symptom severity scores in lower gastrointestinal symptoms between IBS patients with LBT (+) and LBT (-) for methane. There were no significant differences in the severity scores of IBS symptoms between the groups.

• 

  Fig. 3 The correlation between symptom severity scores and gas amounts during LBT in the LBT (+) IBS patients. The severity scores of bloating, flatulence and abdominal pain were weakly correlated with gas amounts calculated by AUC in the LBT curve.

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