Follow-up of coeliac disease with the novel one-hour 13C-sorbitol breath test versus the H2-sorbitol breath test.

Background. We recently developed a C-13-sorbitol breath test (C-13-SBT) as an alternative to the H-2-sorbitol breath test (H-2-SBT) for coeliac disease. In this study we compared the diagnostic properties of the H-2-SBT and the C-13-SBT in follow-up of coeliac disease. Material and methods. Twenty-seven coeliac patients on a gluten-free diet (GFD) performed the breath tests. All had been tested before treatment in the initial study of the C-13-SBT, in which 39 untreated coeliac patients, 40 patient controls, and 26 healthy volunteers participated. Five gram sorbitol and 100 mg C-13-sorbitol were dissolved in 250 ml tap water and given orally. H-2, CH4 and (CO2)-C-13 were measured in end-expiratory breath samples every 30 min for 4 h. Increased H-2 concentration >= 20 ppm from basal values was used as cut-off for the H-2-SBT. Sixty minutes values were used as diagnostic index in the C-13-SBT. Results. (CO2)-C-13 levels at 60 min increased in 20/26 treated coeliac patients (77%) after GFD, but were significantly lower than in control groups. Out of 20 patients who had a positive H-2-SBT before GFD, 12 had a negative H-2-SBT after GFD. Peak H-2 concentrations were not correlated with C-13-SBT results. Conclusion. The study confirms the sensitivity of a one-hour C-13-SBT for small intestinal malabsorption. The C-13-SBT has superior diagnostic properties compared with the H-2-SBT in follow-up of coeliac disease.