Test-retest reproducibility of hydrogen breath test for lactose maldigestion in preschool children.

The test-retest reproducibility of the H2 breath test within the same individual has not been rigorously evaluated in preschool children. In the present study, 10 children--5 of whom were diagnosed as lactose-digesters on their first testing, and 5 of whom were diagnosed as lactose-maldigesters at first screening--were retested under identical conditions of a second opportunity. In each case, the same diagnostic classification was provided, for a reproducibility of 100%. Regression of the area under the curve of the change in breath H2 concentration during the 3 h of the test had a Pearson's correlation coefficient of 0.59 (p = 0.05). The time-course of 3-h H2 breath tests in 43 children with lactose maldigestion revealed a peaking of the concentration of H2 most commonly 120 min following the oral dose of 240 ml whole milk. Seventy-seven percent of the children who eventually proved to be lactose maldigesters were so diagnosed by the end of the second hour of the breath test. Thus, even the abbreviated breath sampling schedule used in children is sensitive, and few maldigesters would go undetected because of a late rise in breath H2 concentration.