Hydrogen Breath Test
Medical Author:
Jay W. Marks, M.D.
What is the hydrogen breath test?
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 man, 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. 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 colonic 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
had a chance to completely traverse the small intestine to be fully digested and absorbed.
Some of the hydrogen produced by the bacteria 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.
When is hydrogen breath testing used?
Hydrogen breath testing is used in 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 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 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.
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