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Although often used as a reference standard in the breath hydrogen test(BHT), lactulose fermentation produces more hydrogen, compared to starch, and may there fore not be ideal. This study compares inulin with lactulose as reference standa rd in the study of carbohydrate malabsorption. Seventeen patients with malabsorp tion due to chronic pancreatitis and 15 normal controls were studied. Following overnight fasts, BHTs were performed after ingesting 10 g lactulose, 10 g inulin , and 200 g(16 g highly resistant starch) maize meal. Lactulose fermentation pro duced significantly more hydrogen than inulin in patients with malabsorption (97 ±20 vs 45±22 ppm·hr; P < 0.05) and controls (43 ±18 vs 21 ±10 ppm·hr; P < 0.05). Patients produced more hydrogen than controls with both standards (lactul ose, 97 ±20 vs 43 ±18 ppm·hr, P < 0.05; inulin 45 ±22 vs 21 ±10 ppm·hrs; P < 0.05), suggesting adaptation of the colonic flora. Calculated CHO malabsorpti on was 2.5 ±0.8 vs 5.2 ±3.8 g with lactulose and 5.2 ±3.1 vs 11.2 ±9.6 g wit h inulin as standards in controls and patients, respectively (P < 0.05). Lactulo se produces more breath hydrogen than inulin. Calculation of CHO malabsorption u sing these standards is therefore not comparable.
This often mixed with lactulose as reference standa rd in the study of carbohydrate malabsorption (BHT), lactulose fermentation produces more hydrogen, compared to starch, and may there fore fore not be ideal. Seventeen patients with malabsorption due to chronic pancreatitis and 15 normal controls were studied. Following overnight fasts, BHTs were performed after ingesting 10 g lactulose, 10 g inulin, and 200 g (16 g highly resistant starch) maize meal. Lactulose fermentation pro duced significantly more hydrogen than inulin in patients with malabsorption (97 ± 20 vs 45 ± 22 ppm · hr; P <0.05) and controls (43 ± 18 vs 21 ± 10 ppm · hr; P <0.05) controls with both standards (lactulose, 97 ± 20 vs 43 ± 18 ppm · hr, P <0.05; inulin 45 ± 22 vs. 21 ± 10 ppm · hrs; P <0.05) on was 2.5 ± 0.8 vs 5.2 ± 3.8 g wi th lactulose and 5.2 ± 3.1 vs 11.2 ± 9.6 g wit h inulin as standards in controls and patients, respectively (P <0.05). Lactulo se produces more breath hydrogen than inulin. Calculation of CHO malabsorption u sing these standards is therefore not comparable.