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Breath test for sorbitol malassimilation in gastroenterology: diagnosis and treatment

The sorbitol malassimilation breath test is an important diagnostic method to determine if a person has difficulty properly digesting and absorbing sorbitol, a sugar alcohol found in many foods and sugar-free products. If sorbitol is not sufficiently absorbed in the small intestine, it passes into the large intestine where it is fermented by bacteria. This process can lead to unpleasant symptoms such as flatulence, abdominal pain and diarrhea.

Procedure of the breath test for sorbitol malassimilation:

  1. Preparation
    • The patient should fast (no food or drink intake) 12-14 hours before the test.
    • Some medications or antibiotics can influence the test result, so these should be discussed with the doctor in advance if necessary.
  2. Start of the test
    • At the beginning of the test, an initial measurement of the hydrogen content in the breath is taken to establish a reference.
    • The patient then drinks a solution containing a defined amount of sorbitol (usually 10-20 g).
  3. Breath samples
    • After ingesting the sorbitol solution, the patient must breathe at regular intervals (every 15-30 minutes) into a device that measures the hydrogen content in the breath.
    • If the sorbitol is not completely absorbed in the small intestine, it reaches the large intestine, where bacteria ferment it and release hydrogen gas, which is detected in the breath.
  4. Interpretation of the results
    • An increase in breath hydrogen levels of more than 20-25 parts per million (ppm) above baseline indicates sorbitol malassimilation.
    • A significant increase in the hydrogen content indicates pronounced malassimilation.

Possible symptoms of sorbitol malassimilation:

  • Flatulence
  • Abdominal pain
  • Diarrhea
  • nausea

Sorbitol malassimilation often occurs in patients with irritable bowel syndrome (IBS) or other gastrointestinal disorders, as they may have a reduced ability to absorb sugar alcohols.

This test is a valuable method of diagnosing digestive problems and helps to identify the cause of symptoms such as bloating and diarrhea. If you have any questions or would like to have the sorbitol malassimilation breath test performed, contact our practice for a personal consultation.