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Measurement of small intestinal transit time in children
M S Murphy1, R Nelson, E J Eastham
1Department of Child Health, University of Newcastle-upon-Tyne, England.
Insights
The lactulose hydrogen breath test
Area of Science:
- Gastroenterology and clinical physiology.
Background:
- The lactulose hydrogen breath test is a non-invasive method to measure mouth-to-caecum transit time.
- Its application and reliability, especially in pediatric populations, require further investigation.
Purpose of the Study:
- To investigate the impact of varying lactulose concentrations and administration in a nutrient preparation on transit time measurements.
- To assess the reliability and potential for delayed gastric emptying effects on small bowel transit time estimations.
Main Methods:
- Studied the effects of different lactulose concentrations on mouth-to-caecum transit time.
- Administered lactulose in both standard and liquid nutrient preparations.
- Analyzed day-to-day variability and correlation with age.
Main Results:
- Lactulose concentration significantly influenced transit time measurements.
- Isotonic solutions may provide a more accurate reflection of small bowel transit time by minimizing gastric emptying effects.
- High day-to-day variability was observed, unaffected by concentration changes or nutrient-based solutions.
- No correlation was found between participant age and transit time.
Conclusions:
- Lactulose concentration is a critical factor influencing breath test results for mouth-to-caecum transit time.
- Isotonic solutions are recommended for studies aiming to assess small bowel transit time.
- The test exhibits significant day-to-day variability, impacting its reliability in pediatric and general populations.
- Age does not appear to be a confounding factor in lactulose hydrogen breath test results.
Abstract:
The lactulose hydrogen breath-test provides a non-invasive measure of mouth to caecum transit-time. Its use, particularly in children has not been thoroughly investigated. We have studied the effects on transit time of altering the lactulose concentration of the test solution, and of administering it in a liquid nutrient preparation. Concentration markedly affected transit-time; studies with an isotonic solution may be least affected by delayed gastric emptying, and so may reflect small bowel transit-time. Day-to-day variation was large, and was not reduced by altering lactulose concentration, or by using the liquid nutrient based test solution. There was no correlation between age and transit-time.