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Anyone had a Hydrogen Test

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Irritable Bowel Syndrome
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pandacrazy
Veteran Member
Joined : Jan 2005
Posts : 1326
Posted 8/14/2006 6:33 PM (GMT -8)

Next year my Nexium will be a tier 3 which I probably won't be able to afford at $50 a month along with all my other meds. I talked to both my docs today and the stomach doc is going to do the hydrogen test after I am done with the antibiotics for my sinus infection. My other doc put me back on pain pill ultram and zantac at bedtime. Sure hope it helps. I need some sleep. I see the stomach doc next Friday the 25th. Well I am off to get ready for bed. Barb

P.S. I think you should contact your doc.

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Yowie
Regular Member
Joined : May 2006
Posts : 91
Posted 8/19/2006 3:49 AM (GMT -8)
bit of information i found about the hydro breath test... looks like i'll be there for quite some time on tuesday.. about 3 to 5 hours. hope they find something..





MedicineNet.com for Health and Medical Information

Source: http://www.medicinenet.com


Hydrogen Breath Test
Medical Author: Jay W. Marks, M.D.

* What is the hydrogen breath test?
* When is hydrogen breath testing used?
* How does hydrogen breath testing work?
* How is hydrogen breath testing performed?
* How are the results of hydrogen breath testing interpreted?
* What are the limitations of hydrogen breath testing?
* Are there other ways in which hydrogen breath testing can be used?
* What are the side effects of hydrogen breath testing?
* What are the alternatives to hydrogen breath testing?

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.

How does hydrogen breath testing work?

The bacteria in the colon, including the anaerobic bacteria, are able to digest and use sugars and carbohydrates as food. When the anaerobic bacteria digest sugars and carbohydrates, they convert some of them into gases, most commonly hydrogen. They also may produce and release into the colon other substances, for example, substances that cause the colon to secrete water and cause diarrhea. As previously discussed, some of the hydrogen gas is absorbed by the colon into the blood and is eliminated in the breath where it can be measured. As long as little sugar or carbohydrate reaches the colon, the small amounts of gas and other substances that are produced do not cause a problem. When larger amounts of sugar or carbohydrate reach the colon because they are not digested and absorbed in the small intestine, larger amounts of gas and substances are formed in the colon.

For example, if an individual digests and absorbs the sugar in milk (lactose) normally, then none of the lactose that is given for the test reaches the colon, and no increase in the concentration of hydrogen in the breath is seen during the breath test. On the other hand, if the individual does not digest and absorb the lactose completely, that is, he or she is lactose intolerant, the lactose travels through the small intestine and enters the colon where the bacteria digest it and produce hydrogen. An increase in hydrogen in the breath then is seen. Other sugars for which poor digestion can be diagnosed by breath testing include sucrose and fructose (found in corn syrup), and sorbitol (a sugar that is used as a low-calorie sweetener).

There are ways other than abnormal digestion of dietary sugars by which the bacteria can cause problems. Unlike in the colon, the number of hydrogen-producing, anaerobic bacteria in the small intestine is small. If, however, large numbers of hydrogen-producing bacteria move into the small intestine from the colon, a condition called bacterial overgrowth of the small bowel, the bacteria may digest the sugars and carbohydrates before the small bowel has had a chance to digest and absorb them and produce large amounts of hydrogen.

Finally, if individuals have abnormally rapid passage of food through the small intestine, there may not be enough time for the small intestine to digest and absorb sugars and carbohydrates. This results in the entry of larger amounts of sugar and carbohydrate into the colon where the bacteria can digest and convert them to gas.

To diagnose bacterial overgrowth and rapid transit through the small intestine, a sugar that is not digested and absorbed by man, such as lactulose, usually is used. In the case of rapid passage through the small intestine, the sugar passes quickly through the small intestine and into the colon so that hydrogen is found in the breath very soon after ingestion of the sugar. In the case of bacterial overgrowth, production of hydrogen occurs twice during the test. Once as the sugar passes the bacteria in the small intestine and again when the sugar enters the colon.

How is hydrogen breath testing performed?

Prior to hydrogen breath testing, individuals fast for at least 12 hours. At the start of the test, the individual blows into and fills a balloon with a breath of air. The concentration of hydrogen is measured in a sample of breath removed from the balloon. The individual then ingests a small amount of the test sugar (lactose, sucrose, sorbitol, fructose, lactulose, etc. depending on the purpose of the test). Additional samples of breath are collected and analyzed for hydrogen every 15 minutes for three and up to five hours.

How are the results of hydrogen breath testing interpreted?

The interpretation of the results of hydrogen breath testing depends on the sugar that is used for testing and the pattern of hydrogen production after the sugar is ingested.

After ingestion of test doses of the dietary sugars lactose, sucrose, fructose or sorbitol, any production of hydrogen means that there has been a problem with digestion or absorption of the test sugar and that some of the sugar has reached the colon. When rapid intestinal transit is present, the test dose of non-digestible lactulose reaches the colon more quickly than normal, and, therefore, hydrogen is produced by the colonic bacteria soon after the sugar is ingested. When bacterial overgrowth of the small bowel is present, ingestion of lactulose results in two separate periods during the test in which hydrogen is produced, an earlier period caused by the bacteria in the small intestine and a later one caused by the bacteria in the colon.

What are the limitations of hydrogen breath testing?

There are several limitations to hydrogen breath testing. For unclear reasons, testing for bacterial overgrowth of the small bowel with lactulose can diagnose only 60-70% of cases. (This insensitivity of the test may be due in part to the strict criteria that are used for interpreting a test as abnormal. Less strict criteria may diagnose overgrowth more often.) In addition, with bacterial overgrowth there may be an overlap of the early and later periods of hydrogen production that can be misinterpreted as a single period characteristic of rapid intestinal transit. Finally, some normal individuals may have slow transit through the small intestine making prolonged testing-up to 5 hours-necessary, and many individuals are unwilling to undergo such prolonged testing.

Some individuals do not have bacteria that produce hydrogen, and in these individuals hydrogen breath testing is not possible. Most of these individuals have bacteria that produce a different gas, methane. (There also are individuals who produce both hydrogen and methane.) Methane can be measured in the breath just like hydrogen, and the production of methane can be used for diagnosis in the same way as hydrogen. There is much less experience with methane, however, and the production of methane is more complex than the production of hydrogen. Therefore, it is not clear if the pattern of methane production after ingestion of sugars can be interpreted in the same way as hydrogen production, particularly for the diagnosis of bacterial overgrowth.

A pattern of hydrogen production that is typical for bacterial overgrowth does not necessarily mean that an individual's symptoms are caused by the overgrowth. For example, there may be anatomic abnormalities of the small intestine such as narrowing or functional abnormalities in the way the muscle of the small intestine works. These abnormalities can cause symptoms of bloating, distention, pain, and diarrhea themselves, but they also can lead to bacterial overgrowth with its similar symptoms. Therefore, it may be an underlying abnormality that is responsible for the symptoms and not the bacterial overgrowth. The only way to differentiate between the two causes of symptoms-an underlying problem or bacterial overgrowth--is to treat and eradicate the bacteria. If the symptoms disappear, then it is more likely that it is the overgrowth rather than the underlying abnormality that is responsible for the symptoms.

Any condition that results in the delivery of undigested or unabsorbed food to the colon may result in abnormal breath tests when dietary sugars are used for testing. Both pancreatic insufficiency and celiac sprue can cause abnormal breath tests, in the former instance because pancreatic enzymes that are necessary for the digestion of carbohydrates are missing, and in the latter instance because the lining of the small intestine is destroyed, and digested food cannot be absorbed. It may be necessary to exclude these causes of abnormal breath tests by additional tests-pancreatic function tests and small intestinal biopsy.

Are there other ways in which hydrogen breath testing can be used?

Antibiotics are used for treating bacterial overgrowth of the small bowel; however, any one antibiotic may be effective at eliminating the overgrowing bacteria only 50-60% of the time. Therefore, if symptoms do not disappear in an individual following treatment with antibiotics, it may be useful to repeat the breath test to determine if the antibiotics have eliminated the bacteria. If not, a different antibiotic or non-antibiotic treatment can be tried.

What are the side effects of hydrogen breath testing?

The side effects of hydrogen breath testing are exactly what one would expect to see in individuals who poorly digest and absorb sugars and carbohydrates, i.e., bloating, distention, pain, and diarrhea. When lactulose is used these symptoms are unlikely to occur or are mild because the dose of lactulose used for testing is small.

What are the alternatives to hydrogen breath testing?

For diagnosing lactose intolerance, an alternative procedure to breath testing requires blood samples to be taken after the ingestion of lactose. If the digestion and absorption of lactose is normal, the levels of glucose in the blood should rise. The elevation of blood glucose occurs because the lactose is broken down into its two component sugars, galactose and glucose, as it is absorbed into the blood. A second alternative is to give a dose of lactose (or other dietary sugar) and observe an individual for symptoms. If the individual is intolerant, bloating, distention, pain, flatulence, and diarrhea are likely to occur. A third alternative is a trial of a diet in which the potentially-offending sugar is strictly eliminated. All of these alternatives, however, have limitations and problems.

Bacterial overgrowth can be diagnosed by culturing (growing) the bacteria from a sample of fluid from the small intestine and counting the numbers of colonic bacteria that are present. This procedure requires a tube to be passed through the nose, throat, esophagus and stomach under x-ray guidance so that fluid can be obtained from the small intestine. It is an uncomfortable and expensive procedure, and most laboratories are not able to accurately culture the samples.

An alternative method for diagnosing rapid transit through the small intestine involves eating food that is labeled with a radioactive marker and determining the time it takes for the marker to reach the colon. Progress of the marker through the bowel is assessed with a scanner that acts like a Geiger counter.
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pandacrazy
Veteran Member
Joined : Jan 2005
Posts : 1326
Posted 8/19/2006 6:12 AM (GMT -8)
Wow that is alot of information there. It is very helpful though. Makes me wonder if it is even worth it though to go through that. But then I am back on my pain med for the moment so don't have all the pain at night like usual. My doctor has agreed to do the test though. I will talk to him further about it when I see him next Friday. Thanks for taking the time to post all this information. Barb

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sarah12
Regular Member
Joined : Jul 2006
Posts : 29
Posted 8/20/2006 7:23 AM (GMT -8)
I saw my GI doc on Thursday and she said the hydrogen test isn't all that accurate, so she didn't give it to me but is rather treating me by symptoms for SIBO. However, I don't believe she gave me the right antibiotic, she gave me tetracycline and I believe neomycin is a better one for this condition. I'm hoping after this round and I don't find relief she'll reconsider and give me a better one.

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clydesdale
New Member
Joined : Oct 2005
Posts : 5
Posted 8/21/2006 3:16 AM (GMT -8)
I had this test done last year. It turned out that I don't produce Hydrogen, but Methane.

I had to go have all the tests done again, but with a machine that can read the methane levels.

Turns out that I'm sensitive to Fructose and it made me feel sick, but it didn't give me D. So after a wheat/fructose free diet for a few months, it didn't make much difference so I gave up. I'm still careful to avoid foods high in fructose (fruits), but I'm disappointed that it wasn't the cause.
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Yowie
Regular Member
Joined : May 2006
Posts : 91
Posted 8/21/2006 3:28 AM (GMT -8)
Does anyone know if the Hydrogen Breath Test is the same as the Sibo Breath Test?

If so it looks quite promising.


http://www.irritable-bowel-syndrome.ws/sibo-breath-test.htm
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Yowie
Regular Member
Joined : May 2006
Posts : 91
Posted 8/21/2006 7:54 PM (GMT -8)
Well that went rather well.

Spend 3 hours at the gastro dept of the hospital. First off, i started fasting at around 7pm last night drinking only water. So this morning, i arrived at the hospital at around 9am.

There was some confusion as to which hydrogen test i was taking. There are a few apparently. There's the one for helicobacter, there's one for bacterial overgrowth, then there's one for lactose intolerance. I suspect the last two are the same test. They have different sugars they make you drink for different tests.

Anyhow, I went for the bacterial overgrowth test... if that doesn't show anything then i'll go for the helicobacter test another time. they take your breath every 15 minutes, and then in the last hour every 30 minutes. I haven't got my result. But good news, is i think my body reacted to the sugar.. within about an hour of drinking the sugar, i got cramping and the urge to goto the loo. Hopefully the tests show something up... i'll have my results at the end of the week. *fingers and toes crossed*.
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kgrl17
New Member
Joined : Aug 2006
Posts : 16
Posted 8/24/2006 2:16 PM (GMT -8)
I had the test done and came out positive for it and the medicine to kill the bacteria helped a lot at first. One of my doctors then put me on a second dose b/c she didn't think it worked fully the first time.

BUT then my gastrointeroligist (sp?) found this out and stopped the meds immediatly. He said it will kill all the bacteria in your stomach, including the good bacteria, which will cause even worse problems. Once the good bacteria is gone then the "bad" comes back in and you are generally worse than when you started. So I'm kinda glad I did one round of it but he's one of the top 5 doctors for IBS in the country so I'm thinking I will listen to him!
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Yowie
Regular Member
Joined : May 2006
Posts : 91
Posted 8/24/2006 2:24 PM (GMT -8)
So how are your symptoms now kgrl17? Did you know which hydrogen test you took? Bacterial Overgrowth or H. Pylori?
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pandacrazy
Veteran Member
Joined : Jan 2005
Posts : 1326
Posted 8/24/2006 5:20 PM (GMT -8)
I thought that is why they use the probiotics after the anitbiotics. Barb

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kgrl17
New Member
Joined : Aug 2006
Posts : 16
Posted 8/25/2006 10:18 AM (GMT -8)
I had medication for the bacterial overgrowth. It completely stopped my constipation and with the right diet I felt great for the first week. Now I have mianly IBS D and am i pain all the time . I have so much bloating that I can't leave the house. My doctor said that the bacterial overgrowth meds will kill the probiotics no matter when you take them. That's the whole problem: it kills all good bacteria and then the bad bacterias come back
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Keriamon
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Joined : Jun 2005
Posts : 2976
Posted 8/25/2006 11:31 AM (GMT -8)
Yes, antibiotics will kill off good bacteria, but I have also seen it recommended that you take two and three times the normal amount of probiotics while on antibiotics--so the antibiotics can't possibly kill off all of it--and that you stay on the probiotics for a week or two after quitting the antibiotics so that you can repopulate your intestines with good stuff. That's the key--putting the good stuff in there immeditately afterwards so that you don't have a chance for bad stuff to get hold. But taking probiotics during antibiotics has been proven, in a small test, to reduce the chance of getting diarrhea while on any type of antibiotics (antibiotic-associated diarrhea), so it has its benefits too, even if they can't really repopulate the intestines with good bacteria while you're on the antibiotics.

You may want to try some probiotics now to if they help your bloating and diarrhea any. They can take a while to work, so try them for a couple of weeks, at least.
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kgrl17
New Member
Joined : Aug 2006
Posts : 16
Posted 8/25/2006 2:05 PM (GMT -8)
Has anyone had good luck with Acidophulis probiotics? I've heard good and bad about this type and that's all I have here so I'm wondering if I should take something else
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pandacrazy
Veteran Member
Joined : Jan 2005
Posts : 1326
Posted 8/25/2006 3:35 PM (GMT -8)
Well I saw my stomach doc today and he agreed to do the test but then asked if I wanted to just be treated for it since I have one of the predominant signs  of the bacterial infection which is the bloating and it came on so suddenly. I agreed to that since the test sounds very time consuming. I asked about the probiotics and he said not to take them until after I am done with the antibiotic. Guess I will listen to the doc. He also told me to quit taking the acidophilus until I am done with the antibiotic. I will let you all know if it works or not. Barb 

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missie1227
Veteran Member
Joined : Nov 2005
Posts : 751
Posted 8/25/2006 11:40 PM (GMT -8)
gosh- i just got done with taking 8 days of omnicef ax which is a killer and gave me again c-dif, now for the 4th time this yr i have to take flagyl  to counter it. i took the pearls to keep the good bac in check but evidently it  didnt work and i took 3'x the normal amount

now back to get on the flagly again and then after that difulcan for the yeast over growth it is a merry go round with all this ax  crap.

 

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pandacrazy
Veteran Member
Joined : Jan 2005
Posts : 1326
Posted 8/26/2006 9:21 AM (GMT -8)
I am going to listen to the doc and wait until I am done with the antibiotics to take the probiotics. I started the antibiotics and levbid this morning. It already caused cramps and diarrhea. I sure hope I am not going through this for nothing. Barb

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