Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Eur J Gastroenterol Hepatol. 2011 Nov;23(12):1144-9. doi: 10.1097/MEG.0b013e32834b0e5c.
The clinical utility in patients with bloating is still conflicting. We aimed to evaluate the positivity to lactulose breath test (LBT) in patients with bloating, and to assess the clinical characteristics according to the positivity or subtypes of LBT.
The patients with abdominal bloating undergoing LBT were investigated. Rome III positive irritable bowel syndrome (IBS) and bowel symptoms were surveyed according to the positivity or subtypes of LBT.
The prevalence of IBS and the positivity to LBT was 23.8% (86 of 358) and 29.6% (106 of 358), respectively. The positivity to LBT and the prevalence in subtypes of LBT were not different according to the presence of IBS. The subtypes of LBT positive (+) patients were LBT (H₂) with 61 (57.5%), (CH₄)+ with 30 (28.3%), and (both) positive with 15 (14.2%). The LBT (H₂)+ group was younger, and had higher symptomatic score for the bloating than that in the LBT negative (-) group. The LBT (CH₄)+ group was older, and had higher scores of hard stool and strain than those of the LBT (-) group. In the fasting LBT (H₂)+ group (n=37) diagnosed by increased baseline H₂, the scores for abdominal discomfort, bloating, and flatus were higher than those for the LBT (H₂)+ or LBT(-) groups.
The subtypes of the positivity to LBT according to the gas produced or the fasting H₂ may contribute to specificity or severity of abdominal symptoms regardless of the presence of IBS.
腹胀患者的临床实用性仍存在争议。我们旨在评估腹胀患者乳果糖呼气试验（LBT）的阳性率，并根据 LBT 的阳性或亚型评估临床特征。
对腹胀患者进行 LBT 检查。根据 LBT 的阳性或亚型，调查罗马 III 阳性肠易激综合征（IBS）和肠症状。
IBS 的患病率和 LBT 的阳性率分别为 23.8%（358 例中的 86 例）和 29.6%（358 例中的 106 例）。LBT 阳性和 LBT 亚型的阳性率与 IBS 的存在无关。LBT 阳性（+）患者的 LBT 亚型为 LBT（H₂）阳性 61 例（57.5%），（CH₄）+阳性 30 例（28.3%），（两者）均阳性 15 例（14.2%）。LBT（H₂）+组患者年龄较小，腹胀症状评分高于 LBT（-）组。LBT（CH₄）+组年龄较大，硬便和排便困难评分高于 LBT（-）组。在通过增加基线 H₂诊断的空腹 LBT（H₂）+组（n=37）中，腹部不适、腹胀和排气评分高于 LBT（H₂）+或 LBT（-）组。
根据产生的气体或空腹 H₂对 LBT 阳性的亚型分类可能有助于特异性或腹部症状的严重程度，而与 IBS 的存在无关。
