14C-triolein breath test as a rapid and convenient screening test for fat malabsorption

The 14C-triolein breath test was evaluated as a screening test for fat malabsorption in 50 consecutive patients. After the ingestion of a 30-g fat meal containing 5 microCi 14C-triolein, the breath excretion of 14CO2 was measured at hourly intervals for 6 h and compared with a 3-day faecal excretion of fat. Nineteen patients had steatorrhoea and 31 patients normal fat excretion. The maximum specific activity of CO2 in the breath provided the best means of distinguishing between the two groups, with no false-negative values and nine false-positive values (29%). Our findings confirm that the 14C-triolein breath test is sensitive and has sufficient specificity for screening fat malabsorption, especially among outpatients. If a normal 14C-triolein breath test is obtained, it seems unnecessary to perform measurements of excretion of faecal fat.