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  • Title: Intestinal malabsorption of D-xylose: comparison of test modalities in patients with celiac disease.
    Author: Tveito K, Brunborg C, Bratlie J, Askedal M, Sandvik L, Lundin KE, Skar V.
    Journal: Scand J Gastroenterol; 2010 Nov; 45(11):1289-94. PubMed ID: 20626306.
    Abstract:
    OBJECTIVE: The aim of the study was to compare three different D-xylose test modalities for small intestinal malabsorption, using patients with celiac disease and healthy persons as experimental models. MATERIAL AND METHODS: Ninety-one untreated celiac patients, 98 treated celiac patients, and 43 healthy subjects performed the (13)C-D-xylose breath test. 1-h plasma D-xylose levels were measured in 48 untreated patients, 41 treated patients and 41 healthy controls. 4-h urine D-xylose excretion was measured in 47 untreated patients, 51 treated patients and 42 healthy controls. 100 mg of (13)C-D-xylose and 5 g of D-xylose were dissolved in 250 ml tap water and given orally. (13)CO(2) was measured in breath every 30 min for 4 h. Blood was sampled after 1 h, and urine collected after 4 h. RESULTS: Test sensitivity/specificity for celiac disease was 88%/84% with the (13)C-D-xylose breath test, 65%/71% with the 1-h plasma D-xylose test, and 55%/74% with the 4-h urine D-xylose excretion test. Breath test results improved significantly in the treated celiac group compared to untreated patients, but were not normalized compared to healthy controls. No difference was found between 1-h plasma D-xylose levels and 4-h urinary D-xylose excretion in treated celiac patients and healthy controls. CONCLUSIONS: The (13)C-D-xylose breath test was superior to D-xylose testing in plasma and urine for assessment of small intestinal malabsorption with considerably higher sensitivity and specificity for untreated celiac disease.
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