Mouth to pouch transit after restorative proctocolectomy: Hydrogen breath analysis correlates with scintigraphy

Charles A. Ternent, Alan G. Thorson, Garnet J. Blatchford, Mark A. Christensen, Jon S. Thompson, Stephen J. Lanspa, Thomas E. Adrian

Research output: Contribution to journalArticle

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Abstract

objectives: Fast intestinal transit may be responsible for slow adaptation and unacceptable steady-state function after restorative proctocolectomy. Investigation of Gi transit time may be valuable in such a setting. We hypothesized that postprandial hydrogen breath tests may yield transit data that correlate with technetium-labeled meal scintigrams. METHODS: This study compared intestinal transit after a lactulose and bean meal via the breath hydrogen and scintigraphy methods in 21 ileoanal pouch subjects. The meal consisted of baked beans (425 g), 30 ml (20 g) lactulose syrup, 1 mCi99mtechnetium sulfur colloid in finely chopped liver and 170 ml tap water. The meal contained 120 Kcal (70% carbohydrate, 18% protein and 12% fat). RESULTS: Of 21 pouch subjects, 11 (53%) had breath tests and scintigraphy transit studies that differed by 5-21 min. Three of 21 (14%) scintigraphy mouth to pouch transit times were faster than breath test transits by 43-107 min. Seven of 21 (33%) subjects did not have breath test peaks >10 ppm. Mouth to pouch transit for breath hydrogen (104 ± 16 min) and scintigraphy (98 ± 7 min) tests had significant correlation (r = 0.96, p <0.0001) among subjects with alveolar hydrogen peaks and accurate scintigrams (n = 11). Scintigrams were five times more expensive than breath tests. CONCLUSIONS: A peaking hydrogen breath test provides an alternative to scintigraphy for estimating intestinal transit after ileoanal pouch.

Original languageEnglish
Pages (from-to)1460-1463
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume96
Issue number5
DOIs
StatePublished - May 2001

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Restorative Proctocolectomy
Breath Tests
Radionuclide Imaging
Mouth
Hydrogen
Meals
Lactulose
Colonic Pouches
Technetium
Colloids
Sulfur
Fats
Carbohydrates
Water
Liver

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Mouth to pouch transit after restorative proctocolectomy : Hydrogen breath analysis correlates with scintigraphy. / Ternent, Charles A.; Thorson, Alan G.; Blatchford, Garnet J.; Christensen, Mark A.; Thompson, Jon S.; Lanspa, Stephen J.; Adrian, Thomas E.

In: American Journal of Gastroenterology, Vol. 96, No. 5, 05.2001, p. 1460-1463.

Research output: Contribution to journalArticle

Ternent, Charles A. ; Thorson, Alan G. ; Blatchford, Garnet J. ; Christensen, Mark A. ; Thompson, Jon S. ; Lanspa, Stephen J. ; Adrian, Thomas E. / Mouth to pouch transit after restorative proctocolectomy : Hydrogen breath analysis correlates with scintigraphy. In: American Journal of Gastroenterology. 2001 ; Vol. 96, No. 5. pp. 1460-1463.
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abstract = "objectives: Fast intestinal transit may be responsible for slow adaptation and unacceptable steady-state function after restorative proctocolectomy. Investigation of Gi transit time may be valuable in such a setting. We hypothesized that postprandial hydrogen breath tests may yield transit data that correlate with technetium-labeled meal scintigrams. METHODS: This study compared intestinal transit after a lactulose and bean meal via the breath hydrogen and scintigraphy methods in 21 ileoanal pouch subjects. The meal consisted of baked beans (425 g), 30 ml (20 g) lactulose syrup, 1 mCi99mtechnetium sulfur colloid in finely chopped liver and 170 ml tap water. The meal contained 120 Kcal (70{\%} carbohydrate, 18{\%} protein and 12{\%} fat). RESULTS: Of 21 pouch subjects, 11 (53{\%}) had breath tests and scintigraphy transit studies that differed by 5-21 min. Three of 21 (14{\%}) scintigraphy mouth to pouch transit times were faster than breath test transits by 43-107 min. Seven of 21 (33{\%}) subjects did not have breath test peaks >10 ppm. Mouth to pouch transit for breath hydrogen (104 ± 16 min) and scintigraphy (98 ± 7 min) tests had significant correlation (r = 0.96, p <0.0001) among subjects with alveolar hydrogen peaks and accurate scintigrams (n = 11). Scintigrams were five times more expensive than breath tests. CONCLUSIONS: A peaking hydrogen breath test provides an alternative to scintigraphy for estimating intestinal transit after ileoanal pouch.",
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