Original articleFermentation of endogenous substrates is responsible for increased fasting breath hydrogen levels in celiac disease
Section snippets
Patients
Thirty-nine untreated CD patients (20 of them women; mean age 33 ± 5 years, range 22-45) and 23 treated ones (12 women; mean age 35 ± 5 years, range 23 - 47) took part in the study. In 25 untreated patients CD was suspected on the basis of the presence of the classical symptoms of malabsorption (diarrhea, steatorrhea, weight loss); in the remaining 14, CD was diagnosed on the basis of the following conditions: iron-deficiency anemia (n = 7), first-degree kinship with a CD patient (n = 3),
Results
Table I confirms that FBH levels are significantly higher in patients with untreated CD than in patients with treated disease or in healthy volunteers. We noted no difference between the last 2 groups. Dividing the group of patients with untreated CD on the basis of the pattern of clinical presentation, we saw that patients with overt malabsorption at the time of diagnosis had FBH levels significantly higher than those in patients with minor symptoms (Fig 1).
With regard to mouth-to-cecum
Discussion
Increased FBH excretion is a common feature in patients with untreated CD,10, 12 but until now, the pathophysiological mechanism responsible for this finding was unknown. The prevalence of increased FBH levels was higher in patients with malabsorption symptoms (diarrhea, steatorrhea, weight loss) than in patients without overt malabsorption (iron-deficiency anemia, first-degree kinship with a CD patient, dermatitis herpetiformis, alopecia areata, recurrent aphthous stomatitis). This finding
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