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The hydrogen (H 2 ) breath test is a non-invasive investigation used to diagnose lactose intolerance (LI). Patients with LI may also expire increased amounts of methane (CH 4 ) during a lactose test. The aim of this study is to evaluate the contribution of CH 4 measurements. We tested 209 children (1-17 years old) with symptoms suggesting LI with lactose H 2 and CH 4 breath tests. The result was positive when the H 2 excretion exceeded 20 parts per million (ppm) and the CH 4 was 10 ppm above the baseline. A clinician, blinded for the results of the breath test, registered the symptoms. Of the patient population, 101/209 (48%) were negative for both H 2 and CH 4 ; 96/209 (46%) had a positive H 2 breath test result; 31/96 (32%) were also positive for CH 4 ; 12/209 (6%) patients were only positive for CH 4 . The majority of hydrogen producers showed symptoms, whereas this was only the case in half of the H 2 -negative CH 4 producers. Almost all patients treated with a lactose-poor diet reported significant symptom improvement. These results indicate that CH 4 measurements may possibly be of additional value for the diagnosis of LI, since 5.7% of patients were negative for H 2 and positive for CH 4 , and half of them experienced symptoms during the test.

Hydrogen and Methane Breath Test in the Diagnosis of Lactose Intolerance