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  • Title: The lactulose hydrogen breath test as a measure of orocaecal transit time.
    Author: Jorge JM, Wexner SD, Ehrenpreis ED.
    Journal: Eur J Surg; 1994 Aug; 160(8):409-16. PubMed ID: 7811826.
    Abstract:
    OBJECTIVE: To establish normal values and assess the reproducibility of the lactulose hydrogen breath test in measuring orocaecal transit time in control subjects, and to report results in a group of patients with chronic constipation as a result of colonic inertia. DESIGN: Open study. SETTING: Academic clinic. SUBJECTS: 42 Control subjects (29 women and 13 men) in 25 of whom the test was repeated within 2-4 weeks, and 19 patients. INTERVENTIONS: Lactulose hydrogen breath test. MAIN OUTCOME MEASURES: Sustained increase in hydrogen production of 3 ppm or more. RESULTS: Coefficient of variation within subjects was 8% compared with 38% between subjects; 3 of the control subjects (7%) and 3 of the patients (16%) did not ferment lactulose, the the incidence was similar in men (1/13, 8%) and women (2/29, 7%). Mean (SD) orocaecal transit time was significantly shorter among the 29 women (60 (27) minutes) than among the 11 men (89 (24) minutes) (p < 0.005). There were no significant differences between men in the control group and those with constipation. CONCLUSIONS: The lactulose hydrogen breath test is valuable to assess orocaecal transit time. It is simple, non-invasive, and reproducible, and may be of value in differentiating between generalised hypomotility and colonic inertia.
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