Download Hydrogen breath test - Nottingham University Hospitals NHS Trust

When will I know the results of my hydrogen breath
test?
When the test is completed the results will be discussed with
you. A copy of the results will also be kept in your medical notes.
When you next see your doctor you will be advised of any
treatment which may be necessary.
Feedback
We appreciate and encourage feedback. If you need advice or
are concerned about any aspect of your care or treatment
please speak to a member of staff or contact the Patient Advice
and Liaison Service (PALS):
Hydrogen breath test
Information for patients
Queen’s Day Case Unit
Freephone: 0800 183 0204
From a mobile or abroad: 0115 924 9924 ext. 65412 or 62301
E-mail: [email protected]
Letter: NUH NHS Trust, c/o PALS, Freepost NEA 14614,
Nottingham NG7 1BR
www.nuh.nhs.uk
f you require a full list of references for this leaflet please email
[email protected] or phone 0115 924 9924
ext. 67184.
The Trust endeavours to ensure that the information given here
is accurate and impartial.
Delphy Tomy/Aquiline Chivinge, Queens Day Case Unit © February 2015. All rights
reserved. Nottingham University Hospitals NHS Trust. Review February2017.
Ref: 1233/v2/0215/AM.
This document can be provided in different languages and
formats. For more information please contact:
Queen’s Day Case Unit
Queen’s Medical Centre
E Floor, South Block
Tel: 0115 924 9924 ext. 61912
Public information
Aim of the leaflet
How is lactose intolerance diagnosed?
This leaflet is aimed at people who have bowel symptoms such
as diarrhoea or abdominal discomfort and who have been
advised to have hydrogen breath test. This leaflet aims to
answer any queries you may have regarding the hydrogen breath
test.
If you get symptoms after drinking milk or eating dairy products
or other lactose-containing foods, it is fairly clear that you may
have lactose intolerance. Tests are not usually needed. If there
is any doubt, a test can be performed which involves measuring
the amount of hydrogen you breathe after taking a test dose of
lactose.
Testing for lactose intolerance
You will be asked to fast overnight before a hydrogen breath
test, and to not smoke for 12 hours before the test. No other
preparation is required.
When you arrive at the endoscopy unit you will be asked to
clean your teeth and then give a sample of your breath by
blowing down a tube into an analyser. You will then be given a
lactose drink and breath samples will be collected every thirty
minutes for approximately three hours.
What is a hydrogen breath test?
How is lactose intolerance treated?
A hydrogen breath test is used to investigate bowel symptoms
such as diarrhoea or abdominal discomfort.
Since your symptoms are caused by the consumption of lactose
which is common in milk and dairy products, a dietician may be
asked to discuss a lactose free diet with you.
Section one - testing for bacterial overgrowth
The test can be used for detecting abnormal growth of bacteria
within the small bowel. Bacterial overgrowth can cause a variety
of symptoms including diarrhoea, bloating, wind and abdominal
cramps.
If you have lactose intolerance you should read the labels of
foods and drinks very carefully. Foods containing 'hidden'
lactose may include bread, cakes, cereals, margarine,
dressings, sweets and snacks.
Section two - testing for lactose intolerance
A hydrogen breath test provides information about the digestion
of certain sugars or carbohydrates, such as milk sugar (lactose)
or fruit sugar (fructose). This will help determine whether you are
intolerant to certain sugars.
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Also remember that many tablets contain lactose so you should
check the leaflet that comes with any medication you are taking.
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SECTION TWO—TESTING FOR LACTOSE
INTOLERANCE
What is lactose intolerance?
What causes hydrogen in the breath?
Hydrogen gas in the body is produced by bacteria, normally in
the large intestine. The hydrogen is produced through a
metabolic fermentation process that converts sugar from
carboyhdrates into acids, gases and/or alcohol.
Lactose intolerance is the inability to digest lactose. This is a
sugar which is found in milk and other dairy products. It occurs
when tiny pockets (villi) in the small intestine are unable to
absorb lactose. This may lead to symptoms of cramping,
bloating and diarrhoea.
Some of the hydrogen produced by bacteria enters the blood
stream and is transported to the lungs. It is then exhaled through
normal breathing.
Who suffers from lactose intolerance?
SECTION ONE—TESTING FOR BACTERIAL
OVERGROWTH
What is bacterial overgrowth?
Approximately 20 per cent of patients with irritable bowel
syndrome may suffer from lactose intolerance. It may also occur
in people with no underlying illnesses.
What are the symptoms of lactose intolerance?
You may get bloating or stomach pains. Excessive burping or
passing a lot of wind can occur. You may also get watery
diarrhoea, and itching around your bottom (the anus). These
symptoms tend to develop from one to several hours after
drinking milk or eating dairy products or any other food
containing lactose.
In healthy people large numbers of bacteria live in the large
bowel or colon. The small bowel is relatively free of bacteria.
If food is not moving normally through the small bowel, bacteria
may colonise. This is known as bacterial overgrowth and it may
interfere with normal digestive function and lead to symptoms
such as chronic diarrhoea, flatulence, weight loss and
weakness.
Testing for bacterial overgrowth
A hydrogen breath test is used to test for bacterial overgrowth.
For four weeks before your test, you should not take any
antibiotics.
For one week before your test, do not take any laxatives or
stool softeners. You should also not undergo any test that
requires cleansing of the bowel, such as a colonoscopy or
barium enema.
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The day before your test
You may consume only the following foods and drinks: plain
white bread, plain white rice, plain white potatoes, baked or
boiled chicken or fish, water, non-flavoured (i.e. unsweetened)
black coffee or tea.
Only salt can be used to flavour your food. Butter or margarine
is not permitted. Fizzy drinks are not permitted.
DO NOT EAT OR DRINK ANYTHING ELSE – it could give false
results for the test. Specifically, avoid beans, pasta, cereals, and
high fibre foods. The night before the test, have an early dinner.
For 12 hours before your test
You must not have anything to eat or drink. For example, if your
test is at 9am, you should stop eating and drinking at 9pm the
night before. However, you may continue to take your usual
prescription medicines with a small amount of water. Please
bring all your prescription medications to your appointment.
The day of your test
You should not eat or drink anything in the morning. You may
take your medications with a small amount of water.
If you are diabetic and require insulin or diabetic pills, ask your
doctor if you should change your morning dose. Oral
hypoglycaemic medications are usually not taken that morning
until the test is complete and you return to eating meals as
normal. Ensure you bring insulin or diabetic tablets with you.
DO NOT EAT, DRINK, CHEW GUM OR TOBACCO, SMOKE
CIGARETTES, EAT BREATH MINTS OR CHOCOLATE
BEFORE OR DURING THE TEST.
Do not sleep or exercise while the test is being done. Your test
may last for two to four hours. Please allow yourself sufficient
time to complete the test.
You will first be asked to give a breath sample by blowing down
a tube into an analyser. You will then be given a glucose drink.
Breath samples will then be collected every 30 minutes for
approximately three hours.
Under normal circumstances the amount of hydrogen in your
breath will remain unaltered as the glucose is absorbed in the
small intestine. However, if you have bacterial overgrowth the
glucose will be digested by the bacteria, producing hydrogen
which is released in your breath. If that is the case, we will be
able to measure an increase in the hydrogen content of your
breath samples.
The test is simple and non invasive but is time consuming so
please bring something with you to read. If you are diabetic
please follow the instructions on your appointment letter.
How is bacterial overgrowth treated?
The initial treatment is a course of antibiotics. Most patients then
remain symptom free. However, some people require a repeat
dose of antibiotics. A hydrogen breath test may be repeated to
check whether the bacteria has been eliminated.
Two hours before the test, brush your teeth.
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