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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Hammer, HF; Fox, MR; Keller, J; Salvatore, S; Basilisco, G; Hammer, J; Lopetuso, L; Benninga, M; Borrelli, O; Dumitrascu, D; Hauser, B; Herszenyi, L; Nakov, R; Pohl, D; Thapar, N; Sonyi, M.
European guideline on indications, performance, and clinical impact of hydrogen and methane breath tests in adult and pediatric patients: European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Neurogastroenterology and Motility, and European Society for Paediatric Gastroenterology Hepatology and Nutrition consensus
UNITED EUR GASTROENT. 2021; Doi: 10.1002/ueg2.12133 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Führende Autor*innen der Med Uni Graz
Hammer Heinz
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Abstract:
Introduction Measurement of breath hydrogen (H-2) and methane (CH4) excretion after ingestion of test-carbohydrates is used for different diagnostic purposes. There is a lack of standardization among centers performing these tests and this, together with recent technical developments and evidence from clinical studies, highlight the need for a European guideline. Methods This consensus-based clinical practice guideline defines the clinical indications, performance, and interpretation of H-2-CH4-breath tests in adult and pediatric patients. A balance between scientific evidence and clinical experience was achieved by a Delphi consensus that involved 44 experts from 18 European countries. Eighty eight statements and recommendations were drafted based on a review of the literature. Consensus (>= 80% agreement) was reached for 82. Quality of evidence was evaluated using validated criteria. Results The guideline incorporates new insights into the role of symptom assessment to diagnose carbohydrate (e.g., lactose) intolerances and recommends that breath tests for carbohydrate malabsorption require additional validated concurrent symptom evaluation to establish carbohydrate intolerance. Regarding the use of breath tests for the evaluation of oro-cecal transit time and suspected small bowel bacterial overgrowth, this guideline highlights confounding factors associated with the interpretation of H-2-CH4-breath tests in these indications and recommends approaches to mitigate these issues. Conclusion This clinical practice guideline should facilitate pan-European harmonization of diagnostic approaches to symptoms and disorders, which are very common in specialist and primary care gastroenterology practice, both in adult and pediatric patients. In addition, it identifies areas of future research needs to clarify diagnostic and therapeutic approaches.

Find related publications in this database (Keywords)
fructose
intolerance
lactose
malabsorption
oro-cecal transit time
small intestinal bacterial overgrowth
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