Lactulose loaded hydrogen breath test

The hydrogen test with lactulose determines the level of hydrogen in exhaled air. It is recommended for suspected intestinal diseases, especially SIBO.

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Hydrogen Breath Test with Lactulose – Test Description

The hydrogen breath test helps determine the concentration of hydrogen in the exhaled air after the patient ingests lactulose. Hydrogen is produced during fermentation by bacteria present in the large and small intestines. In some diseases, part of the carbohydrates taken from food are not digested and undergo fermentation. The interpretation of the hydrogen breath test results is primarily used for diagnosing small intestinal bacterial overgrowth (SIBO).

SIBO Test – Indications

A doctor may recommend the hydrogen breath test with lactulose in cases of persistent, recurring bloating and diarrhea or in the case of chronic bowel inflammation. The test is performed in adults and children from the age of 10. The hydrogen breath test cannot be performed in children with hereditary fructose intolerance or if postprandial hypoglycemia is diagnosed or suspected.

Relative contraindications for the test include the use of antibiotics or probiotics, or having had radiography or colonoscopy within the last 4 weeks, as well as ileostomy and acute infection.

Preparation for the SIBO Test

One day before the test, it is recommended to avoid (if not necessary) taking vitamins, minerals, and laxatives or stool-thickening agents. 8–12 hours before the test, no food should be consumed, but still, plain still water (unsweetened and without flavoring) can be drunk in moderation. However, avoid drinking large amounts in the morning on the test day.

On the day of the SIBO test, you should:

refrain from physical activity, smoking, chewing gum, using strong perfumes or aftershave, and wearing lipstick;

avoid taking medications (unless necessary for health reasons).

Before the hydrogen breath test, thoroughly brush your teeth and rinse your mouth (without using specialized products). Do not use denture adhesives. Due to the length of the test, it’s a good idea to bring something to pass the time, such as a newspaper or a book.

A referral from a doctor is required to perform the test.

How is the Hydrogen Breath Test for SIBO Performed?

The SIBO test involves measuring the hydrogen concentration in the exhaled air before taking lactulose, and then again after its ingestion at specific time intervals. The recommended dose is 10 g of lactulose dissolved in 250 ml of water.

The test takes approximately 3 hours. During this time, breath samples are collected from the patient using a special device. This occurs in a fasting state, and then at the 15th, 30th, 60th, 90th, and 120th minutes. Due to the possibility of slowing intestinal transit, the hydrogen breath test is usually continued until the 180th minute. The patient's task is to inhale air, hold it in the lungs for about 15 seconds, and then exhale forcefully through a single-use mouthpiece or mask connected to the analyzer.

Hydrogen Breath Test – Price

The hydrogen breath test with lactulose costs around 410 PLN. For MediClub members, the price is lower by approximately 60 PLN.