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Triolein breath test: a sensitive and specific test for fat malabsorption

A D Newcomer, A F Hofmann, E P DiMagno

Gastroenterology

|January 1, 1979

Summary

The triolein breath test is a simple, accurate screening tool for steatorrhea (fat malabsorption). It demonstrated high sensitivity and specificity in distinguishing steatorrhea from other conditions.

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Area of Science:

Gastroenterology
Diagnostic Medicine
Biochemistry

Background:

Steatorrhea, characterized by excessive fat in stool, requires accurate diagnostic methods.
Existing screening tests for steatorrhea have limitations in accuracy and simplicity.

Purpose of the Study:

To develop and validate a simple, accurate screening test for steatorrhea.
To compare the efficacy of different 14C-labeled triglyceride breath tests against quantitative stool fat analysis.

Main Methods:

Compared quantitative stool fat excretion with breath excretion of 14CO2 after ingesting 14C-labeled trioctanoin, tripalmitin, or triolein.
Study included 24 nonobese subjects with diarrhea (irritable bowel syndrome) and 40 subjects with steatorrhea.
Evaluated sensitivity and specificity of each breath test and compared them to serum carotene and qualitative stool fat tests.

Main Results:

The triolein breath test showed the highest diagnostic accuracy: 100% sensitivity and 96% specificity for steatorrhea.
Trioctanoin and tripalmitin breath tests were sensitive but lacked specificity, yielding high false-positive rates.
The triolein breath test was moderately superior to serum carotene and qualitative stool fat tests in detecting steatorrhea.

Conclusions:

The 14C-triolein breath test is a sensitive, specific, noninvasive, and simple screening method for steatorrhea.
This breath test offers a reliable alternative for diagnosing fat malabsorption compared to existing methods.