HYDROGEN BREATH TEST WITH GLUCOSE IN EXOCRINE PANCREATIC INSUFFICIENCY

The present study was designed to investigate the prevalence of bacter ial overgrowth in patients with exocrine pancreatic insufficiency by u sing the hydrogen breath test with glucose. Thus, in 30 patients with exocrine pancreatic insufficiency tin 15 due to chronic pancreatitis a nd in 15 associated to primary immunodeficiency), established by quant ifying trypsin output before and after stimulation with cerulein using a duodenal perfusion technique, a glucose test was performed by admin istering 50 g of glucose and quantifying H-2 in the breath by gas chro matography. The glucose test was positive in six of 15 patients with c hronic pancreatitis but in only one of 15 immunodeficient patients (p < 0.05). Age, sex, etiology, time of evolution, associated diabetes, p ancreatic calcifications, duodenal pH, or duodenal trypsin output did not differ between patients with and those without bacterial overgrowt h. Previous gastroduodenal surgery was more common in chronic pancreat itis patients with overgrowth (six of six vs. four of nine; p < 0.05). Five patients with a positive glucose test were treated with antibiot ics for 2 weeks and became negative in two of them. These results sugg est that a positive glucose test indicating overgrowth is relatively c ommon in exocrine pancreatic insufficiency due to chronic pancreatic, especially in patients with previous gastroduodenal surgery.