Helicobacter Pylori Infection and Lactose Intolerance Increase Expiratory Hydrogen

Infection with () may cause dyspepsia and/or unexplained functional nonspecific, gastrointestinal complaints of the irritable bowel syndrome (IBS) spectrum. Hitherto, in infected patients with symptoms of the IBS spectrum the occurrence of additional food intolerance/malabsorption is not evaluated. We used a retrospective analysis of charts from 548 patients who presented with gastrointestinal complaints of the irritable bowel syndrome spectrum. An enzyme-linked IgA immunosorbent assay or histologic evaluation of gastric mucosa were used to detect infection. A hydrogen breath (H) test was performed to evaluate fructose malabsorption (FM) and lactose intolerance (LIT). Serum diamine oxidase value of <10 U/ml and a response to a histamine-reduced diet was used to identify histamine intolerance (HIT). We found 293 patients infected with , within these were 58 patients with LIT, 23 LIT patients with FM and 46 LIT patients with HIT. Additionally, 13 lactose- and histamine intolerance patients also had FM. The Kruskal Wallis test and pairwise comparison were used to analyze differences of the area under the curve of expiratory hydrogen. In lactose H breath tests compared with LIT-only patients, LIT with , LIT and with HIT, LIT and with FM showed significantly higher exhaled H levels (p=0.022). Pairwise comparison demonstrated infected patients with LIT exhaled more H compared to LIT-only (p=0.029). with lactose- and histamine intolerance, and with lactose-, histamine intolerance and FM compared to -only patients indicated a significantly higher occurrence of stomach pain during lactose H breath tests (p=0.012 and p=0.005, respectively). We demonstrate that LIT patients with high expiratory H levels in lactose breath tests may have infection and possibly additional food intolerance/malabsorption. Subsequently, besides eradication, a dietician is necessary for an individually tailored reduction- or exclusion diet of symptom triggering food components.