Do you also often have gas in your stomach? Is your stomach full and swollen like a balloon and very difficult to swallow? Sometimes, when you drink a little milk or eat a certain type of fruit, do you feel a lot of discomfort and pain in your stomach? Because of such problems, you may not be able to do your daily tasks properly. In fact, such digestive system problems are very annoying. So, today we are going to talk about a very simple and painless test that will help you find the exact cause of many such problems.
What is this Hydrogen Breath Test?
Simply put, a hydrogen breath test is a medical test that measures the amount of hydrogen gas in your breath when you exhale. It's very simple. You're just asked to breathe into a small bag-like device. The results of this test can give your doctor a lot of important information about some common problems with your digestive system.
In particular, this test is used to identify conditions such as:
- Small Intestinal Bacterial Overgrowth (SIBO): This is when beneficial bacteria that should be in our colon grow too much where they shouldn't, namely in the small intestine.
- Carbohydrate Malabsorption: For example, many people have lactose intolerance , which means they can't digest milk and dairy products. Some people also have difficulty digesting things like fructose (the sugar found in fruit).
- Irritable Bowel Syndrome (IBS): This test helps to diagnose IBS by looking for both SIBO and sugar intolerance.
How can we detect stomach illness from our breath? How does this actually work?
Have you ever felt gassy, bloated, and painful when you pass gas? That gas is often made up of hydrogen gas. There is only one way for hydrogen to be produced in our bodies. That is, when certain bacteria that live in our intestines digest the sugars and carbohydrates we eat. We call this process fermentation .
These bacteria are normally supposed to live in our large intestine, where they help with the digestion process. But in a healthy digestive system, the sugars and carbohydrates we eat are well-digested before they reach the large intestine. If they somehow make it to the large intestine without being properly digested, the bacteria eat them and ferment them, turning them into gas.
Imagine that when you drink milk, your body can't digest the sugar called lactose. Then, that undigested lactose goes straight to your large intestine. The bacteria there "feast" on it, fermenting it, and producing hydrogen gas.
Here's what happens next:
1. This hydrogen gas, which is produced in the intestines, is absorbed into our bloodstream.
2. This gas travels through the blood to our lungs.
3. When we exhale, this hydrogen gas also comes out.
That's the amount of hydrogen that comes out, which is measured with a special device. You drink a certain type of sugar, and then the amount of hydrogen in your breath is measured for several hours. The amount and how quickly it is produced can give your doctor a good idea of your digestive process.
Are there different types of this test?
Yes, the purpose of the test varies depending on the type of sugar solution you are given to drink during this test. Your doctor will decide which type of sugar to give based on the suspected condition.
- Lactose, Fructose, Sucrose Tests: These are done to see if your body can digest certain types of sugar. For example, if you are given a lactose solution and your hydrogen levels are very high, it means you have lactose intolerance .
- Glucose test: This is mainly used to check for SIBO , or small intestinal bacterial overgrowth. The reason is that glucose is a type of sugar that is normally absorbed very quickly by our small intestine. So, if you exhale hydrogen gas very quickly after drinking glucose, it means that the unwanted bacteria that are there have fermented it and produced gas before the small intestine has even had time to absorb it. This can confirm the presence of SIBO.
How should we prepare before the test?
This is the most important part of the test. To ensure that the test results are 100% accurate, you must follow your doctor's instructions exactly. Certain foods, medications, and activities can affect the test results. So, be very careful about the following things.
| Time limit | Do's/Don'ts |
|---|---|
| About a month ago | If you are taking antibiotics or probiotics, talk to your doctor about stopping them. These can change the balance of bacteria in your gut. |
| About a week ago | Avoid smoking. Also, you may need to stop taking laxatives, fiber supplements, and antacids as directed by your doctor. |
| The day before the test | Very important! You should only eat the special diet prescribed for you. You will be advised to eat only low-fiber, easily digestible foods. Oils, fats, sweets, milk and dairy products, and grains (except bread and rice) are often prohibited. It is advisable to eat boiled or baked chicken or fish (with only salt and pepper). Follow the food list given by your doctor or laboratory exactly. |
| On the day of the test | You must fast for 12 hours before the test. This means you must completely abstain from eating or drinking. Avoid exercising or sleeping for a few hours before the test. |
What happens during the test?
This is a very simple process. You won't feel any discomfort.
1. Baseline breath sample: First, you will be asked to exhale through a tube connected to a balloon-like bag. This measures the baseline level of hydrogen in your normal breath.
2. Drinking a sugar solution: Next, you will be given a solution containing a sugar (such as lactose, glucose) selected according to your medical condition.
3. Breath sample collection: After drinking the sugar solution, you will be asked to take breath samples every 15 to 30 minutes for about 2-3 hours.
4. Recording symptoms: During this time, you will be asked to record any discomfort you experience, such as stomach pain, bloating, or gas.
During this time, you can do things like read a book or watch TV, but don't do things like walk or exercise.
Are there any risks or side effects to this?
A breath test is not harmful to the body in any way. It is completely safe. However, it is done to find the cause of your condition and to give you the same type of sugar that causes that condition.
So, if you have a lactose allergy, you may still experience the stomach discomfort (stomach ache, bloating) that you normally experience after drinking lactose-containing liquids. This is like trying to find the cause of the illness, and trying to make it a little more obvious.
But don't worry about it. These discomforts are temporary. The most important thing is that after this examination, the exact cause of your condition can be identified and the necessary treatment can be started. Then you will be able to completely get rid of these annoying symptoms.
How do you understand the results?
Hydrogen levels are measured in ppm (parts-per-million). When you receive your results, don't be alarmed by the numbers on the report. It's your doctor's responsibility to analyze it and explain it to you in a simple way.
Normally, a healthy person's baseline hydrogen level is less than 16 ppm.
- For sugar intolerance: If the hydrogen level increases by 20 ppm or more above baseline after drinking the sugar solution, it is considered a positive result.
- For SIBO: Here too, the hydrogen level should rise by 20 ppm. But that rise should occur within an hour and a half (90 minutes) . Because that indicates that fermentation is occurring in the small intestine, not the large intestine.
The most important thing: Your doctor will analyze these results and explain your situation to you. So you don't need to worry about the results. He will guide you on the next steps to take.
Digestive problems can be a huge obstacle to our daily lives. Gas, stomach pain, and other issues can take away from the joy we have in life. They can also be a sign that our bodies are not getting the nutrients they need. Fortunately, many of these problems can be diagnosed and treated. A hydrogen breath test is a simple, yet very informative, step in that journey.
Take-Home Message
- The hydrogen breath test is a simple, safe test used to diagnose digestive problems such as gas, bloating, SIBO, and lactose intolerance.
- This works by measuring the hydrogen gas produced in our breath when undigested sugars are fermented by bacteria in the gut.
- For the test results to be accurate, it is essential to strictly follow the diet and other instructions given by the doctor in the days leading up to the test (stopping medication, fasting).
- During the test, you may experience temporary stomach discomfort because you will be drinking the type of sugar that usually causes symptoms. Don't worry about that.
- Always discuss your results and future treatments with your doctor .
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