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Korean J Gastroenterol  <  Volume 75(1); 2020 <  Articles

Korean J Gastroenterol 2020; 75(1): 23-28  https://doi.org/10.4166/kjg.2020.75.1.23
Influencing Factors on Lactulose Breath Test Results
Jin Won Kim*, Seon-Young Park*, Jin Ook Chung1, Hyun A Cho, Dong-Hyun Kim, Jae Hyun Yoon, Chang Hwan Park, Hyun Soo Kim, Sung Kyu Choi and Jong Sun Rew
Divisions of Gastroenterology and Endocrinology1, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Correspondence to: Jong Sun Rew, Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea. Tel: +82-62-220-6296, Fax: +82-62-220-8578, E-mail: jsrew@jnu.ac.kr, ORCID: https://orcid.org/0000-0002-6405-9656
Received: December 7, 2019; Revised: December 22, 2019; Accepted: January 3, 2019; Published online: January 25, 2020.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background/Aims: This study aimed to identify the demographic and clinical factors associated with positive breath-test results and to assess the relationship between hydrogen and methane production in patients with suspected irritable bowel syndrome (IBS).
Methods: The demographic and clinical factors of 268 patients with suspected IBS, who had undergone a lactulose breath test, were analyzed.
Results: Of 268 patients included in this study, 143 (53.4%) were females. The median age and BMI of the patients was 58.0 years (range, 18.0-80.0 years) and 22.5 kg/m2 (range, 14.4-34.3 kg/m2), respectively. A weak positive correlation was observed between the BMI and baseline hydrogen level (rho=0.134, p=0.031). Women were significantly more likely to show a ≥20 ppm increase in hydrogen within 90 min (early hydrogen increase, p=0.049), a ≥10 ppm increase in methane within 90 min (early methane increase, p=0.001), and a ≥10 ppm increase in methane between 90 min and 180 min (late methane increase, p=0.002) compared to men. The baseline hydrogen level was related to the baseline methane level (rho=0.592, p<0.001) and the maximal hydrogen level within 90 min was related to maximal methane level within 90 min (rho=0.721, p<0.001). Patients with an early hydrogen increase (43.8%) were more likely to show a positive result for an early methane increase compared to patients without an early increase in hydrogen (0%, p<0.001).
Conclusions: Women were associated with high rates of positive lactulose breath-test results. In addition, methane production was correlated with hydrogen production.
Keywords: Lactulose; Breath tests; Irritable bowel syndrome; Difference, sex

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