T-Valves (box of 10)
Disposable Mouthpieces (100)
Disposable Mouthpieces (500)
Disposable Mouthpieces (1000)
The HBT Sleuth
hydrogen breath test is a precision instrument for detecting lactose intolerance. This monitor does hydrogen testing, which is among the gases produced in the intestinal lumen by the bacteriological breakdown of carbohydrates in the intestine. After diffusion into the bloodstream, the H2 is expired in the exhaled breath through the alveoli. This measure of H2 in exhaled breath is used to detect abnormal breakdown or malabsorption of carbohydrates in the intestine.
What Is Lactose Intolerance?
Lactose intolerance is the inability to digest significant amounts of lactose, the predominant sugar of milk. This inability results from a shortage of the enzyme lactase, which is normally produced by the cells that line the small intestine. Lactase breaks down milk sugar into simpler forms that can then be absorbed into the bloodstream. When there is not enough lactase to digest the amount of lactose consumed, the results, although not usually dangerous, may be very distressing. While not all persons deficient in lactase have symptoms, those who do are considered to be lactose intolerant.
Common symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. The severity of symptoms varies depending on the amount of lactose each individual can tolerate.
Some causes of lactose intolerance are well known. For instance, certain digestive diseases and injuries to the small intestine can reduce the amount of enzymes produced. In rare cases, children are born without the ability to produce lactase. For most people, though, lactase deficiency is a condition that develops naturally over time. After about the age of 2 years, the body begins to produce less lactase. However, many people may not experience symptoms until they are much older.
Between 30 and 50 million Americans are lactose intolerant. Certain ethnic and racial populations are more widely affected than others. As many as 75 percent of all African Americans and American Indians and 90 percent of Asian Americans are lactose intolerant. The condition is least common among persons of northern European descent.
Researchers have identified a genetic variation associated with lactose intolerance; this discovery may be useful in developing a diagnostic test to identify people with this condition.
How Is Lactose Intolerance Diagnosed?
The most common tests used to measure the absorption of lactose in the digestive system are the lactose tolerance test, the hydrogen breath test, and the stool acidity test. These tests are performed on an outpatient basis at a hospital, clinic, or doctor's office.
The lactose tolerance test begins with the individual fasting (not eating) before the test and then drinking a liquid that contains lactose. Several blood samples are taken over a 2-hour period to measure the person's blood glucose (blood sugar) level, which indicates how well the body is able to digest lactose.
Normally, when lactose reaches the digestive system, the lactase enzyme breaks it down into glucose and galactose. The liver then changes the galactose into glucose, which enters the bloodstream and raises the person's blood glucose level. If lactose is incompletely broken down, the blood glucose level does not rise and a diagnosis of lactose intolerance is confirmed.
The hydrogen breath test measures the amount of hydrogen in a person's breath. Normally, very little hydrogen is detectable. However, undigested lactose in the colon is fermented by bacteria, and various gases, including hydrogen, are produced. The hydrogen is absorbed from the intestines, carried through the bloodstream to the lungs, and exhaled. In the test, the patient drinks a lactose-loaded beverage, and the breath is analyzed at regular intervals. Raised levels of hydrogen in the breath indicate improper digestion of lactose. Certain foods, medications, and cigarettes can affect the accuracy of the test and should be avoided before taking it. This test is available for children and adults.
The lactose tolerance and hydrogen breath tests are not given to infants and very young children who are suspected of having lactose intolerance. A large lactose load may be dangerous for the very young because they are more prone to the dehydration that can result from diarrhea caused by the lactose. If a baby or young child is experiencing symptoms of lactose intolerance, many pediatricians simply recommend changing from cow's milk to soy formula and waiting for symptoms to abate.
If necessary, a stool acidity test, which measures the amount of acid in the stool, may be given to infants and young children. Undigested lactose fermented by bacteria in the colon creates lactic acid and other short-chain fatty acids that can be detected in a stool sample. In addition, glucose may be present in the sample as a result of unabsorbed lactose in the colon.
How Is Lactose Intolerance Treated?
Fortunately, lactose intolerance is relatively easy to treat. No treatment can improve the body's ability to produce lactase, but symptoms can be controlled through diet.
Young children with lactase deficiency should not eat any foods containing lactose. Most older children and adults need not avoid lactose completely, but people differ in the amounts and types of foods they can handle. For example, one person may have symptoms after drinking a small glass of milk, while another can drink one glass but not two. Others may be able to manage ice cream and aged cheeses, such as cheddar and Swiss, but not other dairy products. Dietary control of lactose intolerance depends on people learning through trial and error how much lactose they can handle.
For those who react to very small amounts of lactose or have trouble limiting their intake of foods that contain it, lactase enzymes are available without a prescription to help people digest foods that contain lactose. The tablets are taken with the first bite of dairy food. Lactase enzyme is also available as a liquid. Adding a few drops of the enzyme will convert the lactose in milk or cream, making it more digestible for people with lactose intolerance.
Lactose-reduced milk and other products are available at most supermarkets. The milk contains all of the nutrients found in regular milk and remains fresh for about the same length of time, or longer if it is super-pasteurized.
What Is Hidden Lactose?
Although milk and foods made from milk are the only natural sources, lactose is often added to prepared foods. People with very low tolerance for lactose should know about the many food products that may contain even small amounts of lactose, such as:
- bread and other baked goods
- processed breakfast cereals
- instant potatoes, soups, and breakfast drinks
- lunch meats (other than kosher)
- salad dressings
- candies and other snacks
- mixes for pancakes, biscuits, and cookies
- powdered meal-replacement supplements
Some products labeled nondairy, such as powdered coffee creamer and whipped toppings, may also include ingredients that are derived from milk and therefore contain lactose.
Smart shoppers learn to read food labels with care, looking not only for milk and lactose among the contents, but also for such words as whey, curds, milk by-products, dry milk solids, and nonfat dry milk powder. If any of these are listed on a label, the product contains lactose.
In addition, lactose is used as the base for more than 20 percent of prescription drugs and about 6 percent of over-the-counter medicines. Many types of birth control pills, for example, contain lactose, as do some tablets for stomach acid and gas. However, these products typically affect only people with severe lactose intolerance.
Lactose Intolerance Breath Test
The HBT Sleuth
hydrogen monitor is used to perform a lactose intolerance breath test. Lactose intolerance is the inability to digest lactose, the sugar found in milk. It causes cramping, bloating, gas or diarrhea any time dairy products are consumed. Lactose intolerance occurs due to the body’s lack of lactase, an enzyme normally produced by the small intestine.
The lactose intolerance breath test is a quick way to discover if a patient has lactose intolerance. Studies indicate that as many as 70% of patients that have lactose intolerance do not relate their symptoms to lactose ingestion. They may even mislead their physicians by denying a connection of their symptoms to their diet. The HBT Sleuth
lactose intolerance breath test is done in the doctor’s office and only requires five minutes of the patient’s time. This hydrogen breath test is easy to use, non invasive and gives the physician immediate results of the lactose intolerance breath test. Lactose intolerance is often recognized for the first time in older patients. They may have endured gas and other symptoms for years without connecting the symptoms to their diet.
The HBT Sleuth hydrogen breath test is exempt by CLIA. The CPT code for this test is 91065. Reimbursement varies from state to state and ranges for $52.68 in WV to $91.10 per test in CA.