13C-octanoic acid breath test (OBT) with a new test meal (EXPIROGer®): Toward standardization for testing gastric emptying of solids

Perri, Francesco; Bellini, Massimo; Portincasa, Piero; Parodi, Andrea; Bonazzi, Patrizia; Marzio, Leonardo; Galeazzi, Francesca; Usai, Paolo; Citrino, Attilio; Usai-Satta, Paolo

doi:10.1016/j.dld.2010.01.001

« Previous Next »Digestive and Liver Disease
Volume 42, Issue 8 , Pages 549-553, August 2010

¹³C-octanoic acid breath test (OBT) with a new test meal (EXPIROGer^®): Toward standardization for testing gastric emptying of solids

Francesco Perri
- Division of Gastroenterology and Digestive Endoscopy, “Madonna del Soccorso” Hospital, San Benedetto del Tronto (AP), Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
- Corresponding author at: Division of Gastroenterology and Digestive Endoscopy, “Madonna del Soccorso” Hospital, Via L. Manara, 3-7, 63039 San Benedetto del Tronto (AP), Italy. Tel.: +39 0735 793539; fax: +39 0735 793539.
Massimo Bellini
- Department of Gastroenterology, Gastroenterology Unit, University of Pisa, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Piero Portincasa
- Department of Internal Medicine and Public Medicine, University Medical School, Bari, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Andrea Parodi
- Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Patrizia Bonazzi
- Department of Gastroenterology, Politechnical University of Marche, Ancona, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Leonardo Marzio
- School of Gastroenterology G. D’Annunzio, University of Chieti-Pescara, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Francesca Galeazzi
- Department of Surgical and Gastroenterological Science, Section of Gastroenterology, University of Padova, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Paolo Usai
- Gastroenterology Unit, University of Cagliari, Monserrato (CA), Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Attilio Citrino
- SOFAR Diagnostic Division, Milan, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.
Paolo Usai-Satta
- Gastroenterology Unit, Brotzu Hospital, Cagliari, Italy
- On behalf of the Italian Group for Gastric Emptying Testing (IGGET). IGGET Members are reported in Appendix A.

Received 20 July 2009; accepted 3 January 2010. published online 29 January 2010.

Abstract

Background

Standardization of the ¹³C-octanoic acid breath test is still lacking.

Aim

To evaluate the accuracy of the ¹³C-octanoic acid breath test using a new standardized ready-to-eat, gluten-, glucose-, and lactose-free muffin.

Methods

Healthy subjects were recruited and sorted by sex and age. Patients with diabetic gastroparesis and untreated celiac disease with known gastric motility disorders were also tested with the new labelled muffin. Expired breath ¹³CO₂ was analysed and t_1/2 was calculated.

Results

Overall, 131 healthy subjects were enrolled. The reference range of t_1/2 was 88±29min with the value of 146min as the upper limit of normal range. No significant difference in t_1/2 was found among subjects sorted by sex or age. The within-subject variability of t_1/2 was 17%. Mean (±standard deviation) t_1/2 values were 179±50min in patients with diabetic gastroparesis (n=8) and 151±20min in those with untreated celiac disease (n=11) (p≤0.001 vs controls).

Conclusions

A new standardized test meal simplifies the execution of the ¹³C-octanoic acid breath test, is not influenced by sex or age, has low intra-individual variability, is palatable, does not cause side effects, and is able to evaluate gastric emptying in both patients and healthy controls. Moreover, it can be used in subjects with lactose intolerance, diabetes, and celiac disease.

Keywords: Dyspepsia, Gastric emptying, Motility disorders, Octanoic acid breath test, Stable isotope