Hydrogen-methane breath test with lactulose

What is a hydrogen and methane breath test (HMBT)?

The hydrogen and methane breath test (HMBT) makes it possible to determine the concentration of hydrogen and methane in exhaled air. Under normal physiological conditions, the concentration of these gases is low or even undetectable. In the course of certain diseases, some of the carbohydrates ingested with food are not digested and undergo fermentation by intestinal bacteria, which leads to the production of hydrogen and methane.

What does the test involve?

HMBT is a simple and non-invasive test performed using a device that measures the concentration of hydrogen and methane in exhaled air.

The test takes about 3 hours. During the visit, breath samples are collected from the patient using a special device. The first measurement (the so-called “baseline measurement”) is performed on an empty stomach. Then, the patient drinks a lactulose solution (recommended dose: 10 g of lactulose dissolved in 250 ml of water), Subsequent measurements are taken every 20 minutes from the 20th to the 120th minute. Due to the possibility of slow intestinal transit, the hydrogen breath test is usually performed until the 180th minute.

The patient is asked to breathe in, hold the air in their lungs for about 15 seconds , and then exhale it through a mouthpiece into a special bag, from which samples are collected for analysis.

Within 24 hours after the test the patient may experience abdominal discomfort, diarrhoea or flatulence.

SIBO test – indications

The hydrogen and methane breath test after lactulose loading may be ordered by a doctor in connection with persistent, recurrent flatulence and diarrhoea. The test is intended for children from the age of 10 years and adults..

Absolute contraindications to the hydrogen breath test include hereditary fructose intolerance and diagnosed or suspected reactive hypoglycaemia.

Relative contraindications include taking antibiotics and/or undergoing a colonoscopy or ileostomy within 4 weeks prior to the test.

Preparation for the hydrogen and methane breath test

In order to obtain reliable results, it is necessary to properly prepare for the test (in particular by following the dietary recommendations).

Before undergoing the test, please make sure to obtain a referral from a doctor.

The results are interpreted by a gastroenterologist or an internist.

When and how will the patient receive the result?

A hard copy of the result will be provided to the patient immediately after the test. Please note: after undergoing the test, the patient should consult the doctor who ordered it so that he/she can interpret the result.