Breath hydrogen test after oral lactose in postgastrectomy patients

The purpose of this study was to compare breath hydrogen tests after oral lactose ingestion in nonoperated subjects and postgastrectomy patients. Simultaneous oral lactose tolerance tests and breath hydrogen tests were performed in 50 subjects. Twenty of the 30 subjects without prior gastric surgery had normal lactase activities and low breath hydrogen concentrations. The other 10 subjects had low lactase levels and increased breath hydrogen concentrations. The remaining 20 subjects had prior gastric surgery. Seven of these had normal lactase activities, no history of milk intolerance and low breath hydrogen concentrations. Two of the postgastrectomy patients had low intestinal lactases, milk intolerance, and high breath hydrogens. The remaining 11 postgastrectomy patients had normal intestinal lactases but high breath hydrogens. Eight of the 11 had milk intolerance while two of the other three had not consumed milk since childhood. From these studies the following conclusions can be reached: 1)a low lactose breath hydrogen test in the postgastrectomy subject correctly identifies the individual with normal lactase activity. However, high breath hydrogen responses, may be found in either those with lactase deficiency or normal lactase activity. 2) Lactose malabsorption would appear to explain the milk intolerance in the postgastrectomy patient with normal lactase activity.