Who should request a breath hydrogen test? A six-year feasibility, sensitivity of clinical suspicion and cost-effectiveness analysis

Ding You Li, Yvonne Barnes, R. E. Thompson, Carmen Cuffari

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives: To assess the feasibility of using an at home breath-sampling technique in patients referred for breath hydrogen testing, and to determine the likelihood for a positive breath hydrogen test (BHT) based on whether the ordering physician is a gastroenterologist or general practitioner. Methods: Breath samples were collected via a nasal prong technique and stored in a collection kit. The breath samples were then analyzed using the Quintron microlyzer. A positive BHT was defined as a rise in hydrogen gas concentration of more than 10 ppm above baseline. Results: Over a six-year period (1996 to 2002), 372 consecutive BHTs were performed, 40 in patients younger than 5 years, 201 in patients aged 5 to 18 years, and 131 in patients older than 18 years. Overall, 45 breath samples (12%) were considered unsatisfactory. Patients younger than 5 years (38%) had a significantly higher (P<0.001) number of unsatisfactory breath samples than the other 2 age groups (5-18 years old [10%], > 18 years old [7%]). Of the 328 satisfactory BHTs, 162 (49%) were positive for either lactose intolerance (90%) or small bowel bacterial overgrowth (10%). The likelihood in obtaining a positive BHT was significantly (P<0.001) higher if the referring physician was a gastroenterologist. Our analysis also suggests a potential cost savings in having gastroenterologists screen patients for suspected lactose intolerance or bacterial overgrowth prior to ordering breath hydrogen testing. Conclusions: The nasal prong technique is a feasible method of performing the BHT at home in children younger than 5 years of age. In the very young (<5 years of age), new and innovative breath sampling techniques are needed to make home testing practical. Since gastroenterologists are more selective than general practitioners in requesting BHTs, the potential cost savings may offset the added cost of a patient referral.

Original languageEnglish (US)
Pages (from-to)266-270
Number of pages5
JournalJournal of Applied Research
Issue number2
StatePublished - 2004


  • Breath hydrogen testing
  • Gastroenterologist
  • General practitioner
  • Lactose intolerance
  • Small bowel bacterial overgrowth

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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