Department of Gastroenterology, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Hospital Universitary Mutua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain.
Curr Opin Clin Nutr Metab Care. 2012 Sep;15(5):494-8. doi: 10.1097/MCO.0b013e328356689a.
Relevance of symptom analysis during hydrogen breath test (HBT) for establishing a clinical diagnosis of sugar intolerance is reviewed.
Evaluation of symptoms developed in response to the ingestion of 50 g lactose could represent a simple screening test to select patients for lactose intolerance testing. Patients who do not develop symptoms do not need to be referred for HBT. In addition, symptoms reported by patients during a negative HBT cannot be at all times attributed to a false-negative test; instead, a 'nocebo' effect is likely to be implicated. On the other hand, in a double-blind randomized study, a dose of 25 g fructose was suggested as the most appropriate for testing individuals with suspected fructose malabsorption, whereas symptom reliability to diagnose fructose intolerance was inaccurate.
Whereas the development of symptoms after a positive HBT may indicate sugar intolerance, it is still not clear whether the absence of symptoms after sugar malabsorption gives any indication as to the role of that sugar in the genesis of patient's complaints. Further studies should evaluate whether the disappearance of symptoms with a sugar-restricted diet after a positive HBT is a better diagnostic criterion of sugar intolerance than the development of symptoms.
分析氢呼气试验（HBT）中症状分析对于建立糖不耐受临床诊断的相关性。
评估对摄入 50 克乳糖后出现的症状的反应，可以代表一种简单的筛选试验，用于选择乳糖不耐受检测的患者。未出现症状的患者无需进行 HBT 检查。此外，在阴性 HBT 期间报告的症状并不总是归因于假阴性试验；相反，可能涉及“反安慰剂”效应。另一方面，在一项双盲随机研究中，建议使用 25 克果糖作为检测疑似果糖吸收不良个体的最佳剂量，而症状对诊断果糖不耐受的可靠性并不准确。
阳性 HBT 后出现症状可能表明存在糖不耐受，但目前尚不清楚糖吸收不良后无症状是否表明该糖在患者症状的发生中起作用。进一步的研究应评估在阳性 HBT 后，限制糖摄入饮食后症状消失是否比出现症状更能作为糖不耐受的诊断标准。
