A novel one-hour 13C-sorbitol breath test versus the H2-sorbitol breath test for assessment of coeliac disease

Objective. The H2-sorbitol breath test (H2-SBT) has previously been suggested as a screening tool for coeliac disease. We developed an alternative 13C-sorbitol breath test (13C-SBT). The aim of the study was to compare the diagnostic properties of the H2-SBT and the 13C-SBT in a clinical setting. Material and methods. Thirty-nine coeliac patients, 40 patient controls (mainly patients with irritable bowel syndrome) and 26 healthy volunteers underwent the breath tests. The patients were given an oral load of 5 g sorbitol and 100 mg 13C-sorbitol dissolved in 250 ml tap-water. H2, CH4 and 13CO2 concentrations were measured in end-expiratory breath samples every 30 min for 4 h. Increased H2 concentration ≥20 ppm from basal values was used as the cut-off for the H2-SBT. Results. The H2-SBT had a sensitivity of 71%, a specificity of 46% versus healthy controls, and a specificity of 25% versus patient controls. Individuals with methane-producing intestinal flora had significantly lower peak H2 concentrations than...