Faculty Collaboration Database

Use of the lactose H2 breath test to monitor mucosal healing in coeliac disease. Acta Paediatr 2002;91(2):141-4

Date

04/16/2002

Pubmed ID

11951999

DOI

10.1080/080352502317285117

Scopus ID

2-s2.0-0036365454 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

UNLABELLED: Confirmation of the diagnosis of coeliac disease requires unequivocal evidence of recovery on a gluten-free diet. The lactose H2 breath test is a non-invasive technique for detecting lactose malabsorption, and this may occur in untreated coeliac disease. The utility of this test was investigated in objectively confirming a response to gluten exclusion. The study included 44 children from 0.9 to 14.75 y of age (median 3.2) with coeliac disease. Five children were asymptomatic, being identified through coeliac antibody screening. Breath tests were performed prior to dietary treatment. If positive, they were repeated at 4-wk intervals following gluten exclusion. Overall, 21/44 (48%) children had positive breath tests at presentation. In 18/21 children on a gluten-free diet, this became negative after 4 wk (86%) and in all the children by 8 wk. In two children with positive tests at 4 wk, problems with dietary adherence were identified. A positive test before treatment was not associated with significant differences in individual symptoms, height, weight and body mass index standard deviation scores, serum haemoglobin or albumin. However, no positive results were found in the asymptomatic patients (p = 0.05). Lactose malabsorption was associated with earlier age of presentation (p = 0.008).

CONCLUSION: The lactose H2 breath test objectively confirms a response to gluten exclusion. In selected cases it can help confirm a diagnosis of coeliac disease. However, the test tends to be less informative in asymptomatic patients, and in older children.

Author List

Murphy MS, Sood M, Johnson T

MESH terms used to index this publication - Major topics in bold

Adolescent
Breath Tests
Celiac Disease
Child
Child, Preschool
Female
Humans
Infant
Lactose
Lactose Intolerance
Male