Protocols for Breath Tests Interpretation Help Standard Dosages and Sampling Intervals for Hydrogen/Methane Breath Tests

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Protocols for Breath Tests Interpretation Help Standard dosages and sampling intervals For Hydrogen/Methane Breath Tests

Breath Test Dosage Mixing Sample Intervals Lactose, Fructose or Sucrose Intolerance:

Lactose Intolerance • Max Dose = 25g Mix dose of Lactose in Collect Baseline, drink Suspected Positive: 8-10 ounces of water. mixed Lactose and collect a • Hydrogen (H ) Production Only: 20 ppm delta increase in Hydrogen from the lowest preceding value in the test. • Patients 55 lbs (24.9kg) or greater = 25g Lactose single breath sample each 2 hour for 3 hours. • Patients less than 55 lbs (24.9kg) = 1g of Lactose for • Methane (CH4) Production Only: 12 ppm delta increase in Methane from the lowest preceding value in the test. (4 Samples Total) each 2.2 lbs (1kg) of patient weight. • Hydrogen/Methane Both Produced: Add both H2 and CH4 values together in each sample. Review for a 15 ppm delta increase from the lowest preceding value. Fructose Intolerance • Max Dose = 25g Mix dose of Fructose in Collect Baseline, drink 8-10 ounces of water. mixed Fructose and collect • Patients 55 lbs (24.9kg) or greater = 25g Fructose a single breath sample each hour for 3 hours. Small Intestinal Bacterial Overgrowth (SIBO): • Patients less than 55 lbs (24.9kg) = 1g of Fructose (4 Samples Total) for each 2.2 lbs (1kg) of patient weight. Suspected Positive: Sucrose Intolerance • Max Dose = 50g Mix dose of Sucrose in Collect Baseline, drink Option 1: Glucose (Dextrose) 8-10 ounces of water. mixed Sucrose and collect • Patients 110 lbs (50kg) or greater = 50g Sucrose • Hydrogen (H ) Production Only: 12 ppm delta increase in a single breath sample 2 every 30 minutes for Hydrogen from the lowest preceding value in the test. • Patients less than 110 lbs (50kg) = 2g of Sucrose for 3 hours. (7 Samples Total) each 2.2 lbs (1kg) of patient weight. • Methane (CH4) Production Only: 12 ppm delta increase in Methane from the lowest preceding value in the test. Small Intestinal • Max Dose = 100g Mix dose of Glucose Collect Baseline, drink Bacterial Overgrowth (Dextrose) in 8-10 mixed Glucose (Dextrose) • Hydrogen/Methane Both Produced: Add both H2 and CH4 (SIBO): • Patients 220 lbs. (100kg) or greater= 100gm of ounces of water. and collect a single breath values together in each sample. Review for a 12 ppm delta Glucose sample every 20 minutes for increase from the lowest preceding value. Option 1: Glucose 3 hours. (10 Samples Total) (Dextrose) • Patients less than 220lbs (100kg); mix 1 Tablespoon of Dextrose/Glucose to each 23 lbs (10.4kg) of Option 2: Lactulose patient’s weight into 8-10 oz of water. • Early increase within the first 2 hours (small intestine) followed by a second increase (colonic response). • Alternatively, for more accurate dosing, mix 1g of Dextrose/Glucose for each 2.2lbs (1kg) of patient • Some patients do not present a double peak, but plateau body weight. instead. This may be due colonic response or distal end SIBO. Option 2: Lactulose • Max Dose = 10g Mix dose of Lactulose Collect Baseline, drink

in 8-10 ounces of water. mixed Lactulose and collect • Hydrogen (H2) Production Only: 20 ppm delta increase in • Patients 25 lbs. (10kg) or greater = 10g of Lactulose a single breath sample Hydrogen from the lowest preceding value in the test. every 20 minutes for • Patients less than 25 lbs. (23kg) = 1g of Lactulose to • Methane (CH ) Production Only: 12 ppm delta increase in 3 hours. (10 Samples Total) 4 each 2.2 lbs. (1kg) of patient’s weight. Methane from the lowest preceding value in the test.

• Hydrogen/Methane Both Produced: Add both H2 and CH4 values together in each sample. Review for a 15 ppm delta Example Dose Measuring for Dextrose/Glucose increase from the lowest preceding value. • Divide Patient Weight by 2.2 to calculate kg (ex. 150lbs/2.2 = 68kg). Dosing Tips • Dose = 1g of Dextrose/Glucose for each kg of patient weight. are located on the These are only guidelines, other determining factors back of this booklet. • The Patient will ingest 68g of Dextrose/Glucose in 8-10 oz of water. known by the physician should be considered.