BREATH HYDROGEN ANALYSIS IN PATIENTS WITH ILEOANAL POUCH ANASTOMOSIS

The possible influence on functional outcomes of hydrogen production i n the ileoanal pouch after restorative proctocolectomy was investigate d by means of lactulose H-2 breath tests. Eight of 15 patients had sig nificant increases in breath hydrogen after 10 g lactulose. One patien t declined to participate in further investigations, the remaining sev en responders had no evidence of small bowel bacterial over-growth aft er glucose H-2 breath tests. The ability to produce hydrogen by anaero bic fermentation of lactulose in the pouch was unrelated to the age of the patients or ofthe pouch. Seven of eight responders had successive breath tests after ingestion of lactulose 20 g and wheat starch 100 g. Five of seven had significant increases after lactulose but none afte r wheat starch. The over erall function of the pouch continence, spont aneity of defecation, and 23 hour stool frequency was significantly be tter in responders than in non-responders. The absence of H-2 producti on of 100 g wheat starch may indicate either increased absorption or d efective fermentation.