Breath Test for Lactose, Fructose
Breath hydrogen test is a way to determine if someone has a fructose or lactose malabsorption issues. As with any breath test (including SIBO), the role of a GP in looking into other pathological conditions such as cancer as a cause of some of the symptoms (bloating, nausea etc), a breath test can help in managing the symptoms of malabsorption of lactose and fructose.
The symptoms of nausea, pain, altered bowel motions, bloating that are present in Inflammatory Bowel Disease (IBD) or Irritable Bowel Syndrome (IBS) can be caused by malabsorption of short-chain carbohydrates. These carbohydrates collectively are known as FODMAPs of which fructose and lactose are part of. The others are fructans, galactans and polyols.
What happens with malabsorption of Lactose/Fructose?
It has been shown that restricting those components of FODMAP can bring symptom improvement (of bloating, bowel motions, nausea, pain, gas) in 75% of those with Inflammatory Bowel Disease.
The presence of these substances that are not absorbed can lead to problems with fermentation of these substances by bowel microbiota and also through causing fluid to come into the bowel by osmosis. This can lead to the gut getting distended and lead to bloating, altered bowel motion and pain through the lining of the bowel becoming sensitive.
Why Do A Breath Test for Lactose/Fructose?
Instead of just going by elimination of these components and therefore looking at symptom improvements through trial and error, a breath test for fructose and lactose can be useful for patients with the functional symptoms (bloating, altered bowel motions, nausea, gas etc). The test should only be ordered if there are symptoms. Tests results, when positive will be sent to a Clinical Dietitian-Nutritionist who is specialized in SIBO specific diet.
How to do the Test?
Please note that if you are allergic to dairy or have type 1 Diabetes, you should not do this test.
In that case, an elimination strategy with the Clinical Dietitian-Nutritionist is the best option.
You can do take the lactose/fructose test as a combination package or do each one separately (cost is different).
In each of these tests, a baseline lactulose test is undertaken. If you are allergic to lactulose, please let the clinic know so that a glucose test kit can be sent instead.
Watch this video on how do a lactulose test at home.
Once you have collected the baseline sample, give yourself two days break and then do your lactose test, doing the 24 hour preparation process again. Similarly, between lactose and fructose test, do take two days break and do the fructose test.
The diet preparation protocol is given here.
You will need a pen and a timer / stop watch on the day of the test.
Home Test for Fructose:
To do a home test for Fructose, you will be sent two kits.
a) The first kit will have:
- A sealed plastic bag with discard bag with the mouthpiece and tube holder on it.
- 10 glass tubes
- Lactulose
- Labels
- Time Sheet
- Instructions sheet
b) The second kit will have:
- A sealed plastic bag with discard bag with the mouthpiece and tube holder on it.
- 4 glass tubes
- Fructose
- Labels
- Time Sheet
- Instructions sheet
Home Test for Lactose:
To do a home test for Lactose, you will be sent two kits.
a) The first kit will have:
- A sealed plastic bag with discard bag with the mouthpiece and tube holder on it.
- 10 glass tubes
- Lactulose
- Labels
- Time Sheet
- Instructions sheet
b) The second kit will have:
- A sealed plastic bag with discard bag with the mouthpiece and tube holder on it.
- 4 glass tubes
- Lactose
- Labels
- Time Sheet
- Instructions sheet
Please follow the instructions in each kit and when done.
A copy of your result will be sent to your referring health practitioner.
What happens with the test results?
If you have a positive test for lactose or fructose intolerance, then it is strongly that a consultation be done to work with a specialized Clinical Dietitian-Nutritionist who can make an appropriate dietary plan for you.