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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