Breathing Test To Tell If Celiac?

[janelyb]

I went to a celiac support group today and this mom told me she had her 4 yr old tested by her son drank something with gluten and then they put a mask on and had him breathe and his levels were way high so it confirmed the celiac susp. Can someone tell me the name of this test???

[Nantzie]

I've never heard of that. That sounds cool.

I'm wondering if it's an alternative medicine technique. Or maybe a private lab developing a new diagnostic test. If you can find out more about it, I'd love to hear more.

I did a search online and found this. It's a test for lactose intolerance, but it sounds like what you're talking about. Maybe someone found a way to test for gluten intolerance using the same technique?

"Lactose intolerance is diagnosed by a simple test called a breath hydrogen test. After a period of fasting from midnight the night before the test, an individual drinks a specified amount of the milk sugar as a syrup. In adults this corresponds to the amount of milk sugar in a quart of milk. They then breathe into a test bag every fifteen minutes for approximately two hours. The breath that they exhale into the bag is analyzed to determine its hydrogen content. During the course of the test individuals who are lactose intolerant will have an increase in the amount of hydrogen that they exhale. If the values for hydrogen increase above a certain value the diagnosis of lactose intolerance is made. Patients who are lactose intolerant may also develop their typical symptoms during the test. "

From Open Original Shared Link

Let us know what you find out.

Nancy

[Rachel--24]

I went to a celiac support group today and this mom told me she had her 4 yr old tested by her son drank something with gluten and then they put a mask on and had him breathe and his levels were way high so it confirmed the celiac susp. Can someone tell me the name of this test???

I've heard of this type of testing for lactose intolerance and bacterial overgrowth.

I cant see how it would be possible to diagnose Celiac with this method of testing?? You cannot determine if antibodies are being produced by the immune system with a breath test.

It would seem impossible to diagnose Celiac in this manner.

Is it possible that this woman is confused as to what her son was being tested for??

[janelyb]

maybe that is what she was talking about because she also mentioned her son is severely allergic to dairy. I must have confused the info she was giving. Either way thanks for the name of it.

[Nantzie]

Got it -

Looked it up on Pubmed.gov . Take a look at this - Open Original Shared Link

Just in case that doesn't come up here's a copy and paste -

1: Dig Dis Sci. 2007 Jan 20; [Epub ahead of print] Links

Comparison of D-Xylose Hydrogen Breath Test With Urinary D-Xylose Test in Indian Children With Celiac Disease.Rana SV, Thapa BR, Pal R.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, House # 137, Sector 15-A, Chandigarh, 160015, India, svrana25@hotmail.com.

D-xylose hydrogen breath test (H(2)BT) may be better parameter in screening for intestinal malabsorption in patients with celiac disease. This study sought to compare D-xylose H(2)BT with urinary D-xylose tests in screening for intestinal malabsorption in patients with celiac disease. A total of 68 children with confirmed celiac disease were enrolled for this study. Five-gram urine D-xylose test and D-xylose H(2)BT were performed simultaneously according to standard methods. Institute ethical clearance and informed consent was taken before starting this study. Of 68 children, 41 were boys and 27 girls of age range 5-14 years; 5-g urine D-xylose test was abnormal in 50% of cases and 5-g D-xylose H(2)BT in 69.9% of cases. D-xylose H(2)BT was able to pick up 19.9% more cases of malabsorption in Indian children with celiac disease. This study indicates that performance of 5-g D-xylose H(2)BT is a better test than 5-g urinary D-xylose test in screening for intestinal malabsorption in patients with celiac disease.

PMID: 17237998 [PubMed - as supplied by publisher]

////////////////////////////

Here's another one -

Follow-up of celiac disease with D-xylose breath test.

Author Casellas F; De Torres I; Malagelada JR

Address Digestive System Research Unit, Hospital General Vall d'Hebron, Barcelona, Spain.

Source Dig Dis Sci, 1996 Oct, 41:10, 2106-11

Abstract Hydrogen breath tests (H2-BT) are commonly used to diagnose carbohydrate malabsorption. Specifically, the H2-BT with D-xylose has been shown to be as valid as the traditional urinary test for the recognition of intestinal malabsorption. We have now investigated the H2-BT with D-xylose in the follow-up of patients with celiac disease. Seventeen patients with celiac disease established clinically and confirmed by jejunal biopsy were studied. H2-BT was performed before and after treatment with a gluten-free diet for at least five months. Alveolar breath samples were obtained before administering orally 25 g of D-xylose and thereafter at 30 min intervals for 5 hr. Samples were analyzed for H2 by chromatography. Simultaneously, the 5-hr urinary excretion of D-xylose was determined by colorimetry. Gluten removal significantly decreased the H2 delta change (from 56.5 +/- 5.9 ppm to 32.2 +/- 8.8, P < 0.05). A similar decrease was observed in the area under the curve (P < 0.05). Conversely, urinary D-xylose excretion increased significantly (P < 0.05). Eleven of the 17 celiacs clinically improved after treatment. The H2-BT normalized in every patient who entered remission on the gluten-free diet, whereas the urinary D-xylose excretion remained abnormal in six of them. In the six nonresponder patients the H2-BT remained high in five, whereas urinary D-xylose excretion paradoxically normalized in 2. We conclude that H2-BT with D-xylose is a useful and practical test for the follow-up of celiac disease and is simpler and more reliable than the urinary D-xylose test.

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I haven't heard about any of this before your post. Very, very interesting.

Nancy

[Rachel--24]

The test wouldnt be useful for diagnosing Celiac. It would only be useful for follow-up with regards to malabsorption. Since malabsorption can occur in anyone for any number of reasons....it cant determine whether or not Celiac Disease is the cause of malabsorption.

The article doesnt say the test is used as a diagnostic tool for Celiac...just as a follow-up on malabsorption.

[janelyb]

thanks Nancy, I'm deffinately gonna inquire more about this when we see the pedi gi next week.

[Nantzie]

You're welcome Janely! I seriously doubt that the ped GI has heard of this. It sounds like something that is still in the research stages and wouldn't be common knowledge. I would ask the mom at the group more about her ped GI. See if you can get his name. Maybe you can get a referral to him. Or maybe your ped GI can talk to him and get more info on the test or the research.

Rachel - I'm wondering if the doctor was using it as part of a group of less invasive tests to determine if he was barking up the right tree. Maybe all signs pointed to a gluten issue but he (or the mom maybe?) didn't want to do blood or biopsy.

It might be useful in adults too because so many of us go gluten-free just to give it a shot with no clear diagnosis.

It will be interesting to hear more about this.

Nancy

[gfp]

I've heard of this type of testing for lactose intolerance and bacterial overgrowth.

I cant see how it would be possible to diagnose Celiac with this method of testing?? You cannot determine if antibodies are being produced by the immune system with a breath test.

It would seem impossible to diagnose Celiac in this manner.

Is it possible that this woman is confused as to what her son was being tested for??

I guess its possible it was confused but also I guess never say never....

Before Dr. fine the idea of faecal testing was poo-poo'ed (pun intended) ...

A couple of years ago they did some experiments with dogs sniffing urine to detect cancer. Not only did the dogs reliably identify the diagnosed patients they also kept giving a false positive on someone who had tested negative and was part of the blind test...

That guy turned out to have very very early stage cancer... which was later confirmed and I hope treated...

anyway... the tinhg is they were not trying to make a doggy test.. what they did was teach the dogs to identify two types of urine ... they didn't know what it was the dogs picked up on, just that they picked up on something... the challenge now is to identify what is was the dogs actually smelled and make a test.

[Rachel--24]

I guess its possible it was confused but also I guess never say never....

Before Dr. fine the idea of faecal testing was poo-poo'ed (pun intended) ...

True...but keep in mind that Dr. Fine hasnt published anything yet. His test is not widely accepted...so basically its still poo-poo'ed by the vast majority.

I tested positive in his testing....accross the board....and I had very high malabsorption to go along with it.

In the end it wasnt gluten that caused that malabsorption. Gluten wasnt my biggest issue and I do not have Celiac. .So....while these types of tests may be somewhat useful...they still dont have the capability to diagnose a specific disease like Celiac.

Note that the people involved in the study were already diagnosed Celiacs....in no way were they using this test for diagnostic purposes.

[janelyb]

You're welcome Janely! I seriously doubt that the ped GI has heard of this. It sounds like something that is still in the research stages and wouldn't be common knowledge. I would ask the mom at the group more about her ped GI. See if you can get his name. Maybe you can get a referral to him. Or maybe your ped GI can talk to him and get more info on the test or the research.

Rachel - I'm wondering if the doctor was using it as part of a group of less invasive tests to determine if he was barking up the right tree. Maybe all signs pointed to a gluten issue but he (or the mom maybe?) didn't want to do blood or biopsy.

It might be useful in adults too because so many of us go gluten-free just to give it a shot with no clear diagnosis.

It will be interesting to hear more about this.

Nancy

I did ask and ironically it is the same pedi GI doc we take our son to. I will deffinately see if she has more info on it for me to pass on. We see her on the 21st

Janel

[Nantzie]

Awesome!

Nancy

[gfp]

True...but keep in mind that Dr. Fine hasnt published anything yet. His test is not widely accepted...so basically its still poo-poo'ed by the vast majority.

I tested positive in his testing....accross the board....and I had very high malabsorption to go along with it.

In the end it wasnt gluten that caused that malabsorption. Gluten wasnt my biggest issue and I do not have Celiac. .So....while these types of tests may be somewhat useful...they still dont have the capability to diagnose a specific disease like Celiac.

Note that the people involved in the study were already diagnosed Celiacs....in no way were they using this test for diagnostic purposes.

Like I've said before it all depends what you decide to call celiac.

As we both know our knowledge of the mechanisms are rather limited, and I expect the definition of celaic to be revised several times as knowledge of it is revised and collated, eventually leading to different classifications of celiac according to different criteria, just as diabetes is split up today. Perhaps some underlying mechanism will be found that makes what we call celiac today (biopsy proven only in mant cases) a subset of a larger disease called celaic or perhaps they will make a new name for the wider issues?

My point is the guy with cancer didn't have cancer according to the available testing methodology at the time but he did have cancer all the same. Indeed a large percentage of males over 60 have cancer and never know about it and a still pretty large number have cancer they do know about but isn't considered life threatening based on their projected life expectancy... just as a large number of people have relatively benign cancers ... but they are not classified as cancer patients ...

What I mean is that according to our current diagnostic tests and understanding we change the definitions.... Dr. Fine's test may prove to be very significant or it may not.... but in many ways our name for a disease its irrelevant because it is based on a classification, in the case of celaic which is defined by testing methology. As that testing methology develops so our classification for the disease changes...

Regarding Dr Fine's test I can hardly be the only one that has noticed my poo takes a different odour when I get glutened.

I had noticed this before I even heard of Dr. Fine's test ... indeed I had noticed this before I was diagnosed celiac at the point at which I discovered all by myself that when I ate wheat based food I felt bad. I used to be essentially gluten-free even then and whenever I travelled I noticed along with the D and cramps that my poo had a different odour... at one point I actually thought it was to do with flying .. since I got this peculiar odour each time I flew... of course this is also when I ate sandwiches, visited my pre-diagnosis mom etc.

[janelyb]

You're welcome Janely! I seriously doubt that the ped GI has heard of this. It sounds like something that is still in the research stages and wouldn't be common knowledge. I would ask the mom at the group more about her ped GI. See if you can get his name. Maybe you can get a referral to him. Or maybe your ped GI can talk to him and get more info on the test or the research.

Rachel - I'm wondering if the doctor was using it as part of a group of less invasive tests to determine if he was barking up the right tree. Maybe all signs pointed to a gluten issue but he (or the mom maybe?) didn't want to do blood or biopsy.

It might be useful in adults too because so many of us go gluten-free just to give it a shot with no clear diagnosis.

It will be interesting to hear more about this.

Nancy

So apparently Sutter Memorial has this high tech machine and Dr Davies suggested it for my son before I asked about it. So hopefully very soon we can do the hydrogen breath test. Until then he still needs to eat gluten...

I just hate glutening him, lately he is doubling over in pain and refusing to eat!

[Nantzie]

So apparently Sutter Memorial has this high tech machine and Dr Davies suggested it for my son before I asked about it.

How cool is that?

Poor kid though. I hope his appt is soon.

Nancy