[Monitoring of postoperative enteral feeding using the H2 breath test]

A group of 24 patients which underwent extensive abdominal surgery (gastrectomy and esophagus resection) were fed with a chemically defined diet by way of a needle catheter jejunostomy starting on day five postoperatively. On the fourth postoperative day the jejunocaecal transit time was measured by hydrogen breath test with a median of 97.5 min. Under enteral nutrition, hydrogen exhalation showed a significant rise in all patients. The 8 patients who developed diarrhea (33%) had significantly elevated hydrogen exhalation in relationship to the patients with no diarrhea. 6-12 h before diarrhea, patients had a significant increase in their hydrogen exhalation in correlation to the beginning of carbohydrate malabsorption. Therefore, the hydrogen breath test is a simple, non-invasive method to evaluate carbohydrate malabsorption and the risk of developing diarrhea under enteral nutrition.