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lüll Hydrogen breath test for the diagnosis of lactose intolerance, is the routine sugar load the best one?Argnani F; Di Camillo M; Marinaro V; Foglietta T; Avallone V; Cannella C; Vernia PWorld J Gastroenterol 2008[Oct]; 14 (40): 6204-7AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25. METHODS: Ninety patients showing high-grade malabsorption at HBT-25 were submitted to a second HBT with a lactose load of 12.5 g. Peak hydrogen production, area under the curve of hydrogen excretion and occurrence of symptoms were recorded. RESULTS: Only 16 patients (17.77%) with positive HBT-25 proved positive at HBT-12.5. Hydrogen production was lower as compared to HBT-25 (peak value 21.55 parts per million (ppm) +/- 29.54 SD vs 99.43 ppm +/- 40.01 SD; P < 0.001). Symptoms were present in only 13 patients. The absence of symptoms during the high-dose test has a high negative predictive value (0.84) for a negative low-dose test. The presence of symptoms during the first test was not useful for predicting a positive low-dose test (positive predictive value 0.06-0.31). CONCLUSION: Most patients with a positive HBT-25 normally absorb a lower dose of lactose and a strict lactose restriction on the basis of a "standard" HBT is, in most instances, unnecessary. Thus, the 25 g lactose tolerance test should probably be substituted by the 12.5 g test in the diagnosis of LI, and in providing dietary guidelines to patients with suspected lactose malabsorption/intolerance.|*Breath Tests[MESH]|*Lactose Tolerance Test[MESH]|*Lactose/administration & dosage/pharmacokinetics[MESH]|Administration, Oral[MESH]|Humans[MESH]|Hydrogen/*metabolism[MESH]|Lactose Intolerance/*diagnosis/metabolism[MESH]|Predictive Value of Tests[MESH] |