Breath Tests


Fructose is a sugar found naturally in fruits, honey and some syrups. Fructose is also a basic component in table sugar (sucrose), and it's used to sweeten many processed foods and beverages. In addition, sorbitol. a sugar alcohol, interferes with fructose during normal digestion and should be avoided. 30% of the population suffers from fructose malabsorption. So if you have fructose intolerance, you should avoid foods that contain fructose and sucrose as well as sorbitol. The phrase "fructose intolerance" is a general term that describes two possible conditions:

  • Hereditary fructose intolerance: People with hereditary fructose intolerance, a rare genetic disorder, lack an enzyme that breaks down fructose. This serious disorder, which is usually diagnosed at a young age, can lead to liver and kidney damage.
  • Fructose malabsorption: People with fructose malabsorption have difficulty digesting fructose. This is a less serious disorder because it doesn't result in liver or kidney damage. But it can cause abdominal pain, gas, bloating and diarrhea.

Fructose is absorbed in the small intestine without help of digestive enzymes. Even in healthy persons, however, only about 25-50g of fructose per sitting can be properly absorbed. Persons with fructose malabsorption may absorb less than 25g per sitting.  In the large intestine, fructose that hasn't been adequately absorbed osmotically reduces the absorption of water and is metabolized by normal colonic bacteria to short chain fatty acids and the gases hydrogen, carbon dioxide and methane. This abnormal increase in hydrogen is detectable with the hydrogen breath test.


Helicobacter pylori (H. pylori)

Helicobacter pylori, a spiral bacterium found in the stomach, is implicated in gastritis, gastric ulcers, and peptic ulcer disease. The urea breath test is a rapid diagnostic procedure used to identify infections by Helicobacter pylori. It is based upon the ability of H. pylori to convert urea to ammonia and carbon dioxide. The difference between the pre and post urea measurements is used to determine infection. This value is compared to a cut-off value. Results below the value are assumed to be negative, those above positive. Urea breath tests are recommended in leading society guidelines as a preferred non-invasive choice for detecting H. pylori before and after treatment. 



Lactose is a sugar formed from galactose and glucose that is most notably found in dairy products. So if you have lactose intolerance, you should avoid foods that contain lactose. Lactose intolerance is the inability to digest significant amounts of lactose, which is the predominant sugar of milk. Close to 50 million American adults are lactose intolerant.

Lactose intolerance results from a shortage of the enzyme lactase, which is normally produced by the cells that line the small intestine. Lactase breaks down milk sugar into simpler forms that can then be absorbed into the blood stream. When there is not enough lactase to digest the amount of lactose consumed, the results, although not usually dangerous, may be very distressing.

Common symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about 30 minutes to two hours after eating or drinking foods containing lactose. The severity of symptoms varies depending on the amount of lactose each individual can tolerate.

The most common tests used to measure the absorption of lactose in the digestive system are the lactose intolerance test, the hydrogen breath test, and the stool acidity test. A clinical response to lactose restriction may also be sufficient, at times, to make the diagnosis.

The lactose breath test is easy and accurate.  The lactose breath test is available at the Heartland Center for Motility within Gastroenterology Consultants.


Small Bowel Bacterial Overgrowth

A healthy small intestine maintains a constant balance of bacteria to ensure normal digestive functioning. The following can alter the bowel’s environment, reducing the number of protective bacteria:

  • Exposure to antibiotics
  • Decreased stomach acid secretion
  • Diminished digestive enzyme production
  • Gastrointestinal obstructions
  • Radiation therapy
  • Motility disorders

When the number of protective bacteria is compromised, it upsets a balance. Some harmful bacteria normally kept in check by the protective bacteria are allowed to grow without restraint. This leads to a condition known as Small Bowel Bacterial Overgrowth (SBBO). If left untreated, the condition can lead to nutrient malabsorption with malnutrition. A simple non-invasive hydrogen breath test can determine if you suffer from SBBO.