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

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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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All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Ternent, C. A., Thorson, A. G., Blatchford, G. J., Christensen, M. A., Thompson, J. S., Lanspa, S. J., & Adrian, T. E. (2001). Mouth to pouch transit after restorative proctocolectomy: Hydrogen breath analysis correlates with scintigraphy. American Journal of Gastroenterology, 96(5), 1460-1463. https://doi.org/10.1016/S0002-9270(01)02362-0