Hydrogen breath test assessment of orocecal transit time: comparison with barium meal study

Orocecal transit time was measured simultaneously by the hydrogen breath test and a barium meal study in 12 hospitalized patients, the objective being to determine whether the former test accurately represents the orocecal transit time, and to establish an adequate criterion for the transit time, based on the former test. Two definitions of orocecal transit time by the hydrogen breath test were evaluated: the time from lactulose ingestion to a sustained increase of over 5 ppm above fasting levels in the end-expiratory hydrogen concentration (definition A) and the interval to that of over 10 ppm (definition B). The orocecal transit time measured by the radiologic method was 63 +/- 9 min (mean +/- SEM), whereas that using definition A of the hydrogen breath test was 74 +/- 9 min, and that using definition B was 87 +/- 10 min. Transit times determined by both definitions closely correlated with that obtained by the radiologic method (A, r = 0.86, p less than 0.01; B, r = 0.81, p less than 0.01). Therefore, elevation of end-expiratory hydrogen concentrations seemed to coincide with cecal appearance of the head of the lactulose load. When the mean transit times were compared with findings in case of the radiologic method, definition A rather than B appeared to be more appropriate to determine orocecal transit time.