Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Aug 15, 2016; 7(3): 256-265
Published online Aug 15, 2016. doi: 10.4291/wjgp.v7.i3.256
Update on diagnostic value of breath test in gastrointestinal and liver diseases
Imran Siddiqui, Sibtain Ahmed, Shahab Abid
Imran Siddiqui, Sibtain Ahmed, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi 74800, Pakistan
Shahab Abid, Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi 74800, Pakistan
Author contributions: Siddiqui I performed the literature search, data accusation and majority of the writing work in first draft, prepared the figures and tables; Ahmed S performed the literature search, data accusation and contributed in writing first draft, help with figures and tables; Abid S conceived the idea, designed the outline and coordinated the writing of the paper; all authors have reviewed the final draft and agreed upon.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors who contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Shahab Abid, Professor and Head, Section of Gastroenterology, Department of Medicine, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. shahab.abid@aku.edu
Telephone: +92-21-34864656 Fax: +92-21-34934294
Received: March 4, 2016
Peer-review started: March 7, 2016
First decision: April 15, 2016
Revised: April 22, 2016
Accepted: May 10, 2016
Article in press: May 11, 2016
Published online: August 15, 2016
Processing time: 159 Days and 2 Hours
Abstract

In the field of gastroenterology, breath tests (BTs) are used intermittently as diagnostic tools that allow indirect, non-invasive and relatively less cumbersome evaluation of several disorders by simply quantifying the appearance in exhaled breath of a metabolite of a specific substrate administered. The aim of this review is to have an insight into the principles, methods of analysis and performance parameters of various hydrogen, methane and carbon BTs which are available for diagnosing gastrointestinal disorders such as Helicobacter pylori infection, small intestinal bacterial overgrowth, and carbohydrate malabsorption. Evaluation of gastric emptying is routinely performed by scintigraphy which is however, difficult to perform and not suitable for children and pregnant women, this review has abridged the 13C-octanoic acid test in comparison to scintigraphy and has emphasized on its working protocol and challenges. A new development such as electronic nose test is also highlighted. Moreover we have also explored the limitations and constraints restraining the wide use of these BT. We conclude that breath testing has an enormous potential to be used as a diagnostic modality. In addition it offers distinct advantages over the traditional invasive methods commonly employed.

Keywords: Breath tests; Diagnostic techniques; Lactase deficiency; Gastrointestinal tract; Helicobacter pylori

Core tip: The aim of this review is to have an insight into the principles, methods of analysis and performance parameters of various breath tests available for diagnosing gastrointestinal disorders. Furthermore we have also explored the limitations and constraints restricting the wide use of these tests.