RESUMO
Introducción: En la literatura se describe poca utilización y conocimiento de las pruebas de hidrógeno en aliento por la comunidad médica. Este trabajo busca aportar datos cuantitativos sobre el conocimiento y uso de este tipo de pruebas en la comunidad médica de Monterrey, Nuevo León, México. Materiales y Métodos: Se elaboró y valido mediante metodología DELPHI una encuesta que evaluó los conocimientos y uso de pruebas de hidrógeno en aliento. Para el análisis de datos se utilizaron estadísticas descriptivas. Resultados: Se obtuvieron 158 encuestas siendo la mayor parte de los encuestados pediatras (34%). La mayoría de los encuestados refirió no conocer las pruebas (69%), no haberlas indicado (93%) y desconocer su costo (95,6%). El 67,1% de los encuestados refirieron el desconocimi ento como factor limitante para la indicación de estas pruebas en su práctica. Los médicos consideraron útiles las pruebas de hidrógeno en aliento para el diagnóstico de intolerancia a carbohidratos (38,6%), síndrome de sobrecrecimiento bacteriano intestin al (31,6%) y ninguna opción (32,9%). Discusión : Los resultados indican que las pruebas son poco utilizadas y se tiene un considerable desconocimiento sobre ellas en nuestro medio. Esto indica la necesidad de dar mayor difusión y educar a la comunidad médic a sobre su utilidad.
Introduction: In the literature, it is reported an underuse and limited knowledge of hydrogen breathe tests by the medical community. This work aim to provide quantitative data about the knowledge and use hydrogen breath test in the medical community of Monterrey, Nuevo León, México. Materials and methods: A survey was developed and validated thought DELPHI methodology. The survey evaluated knowledge and use of hydrogen breath tests. For the data analysis, descriptive statistics was used. Results: A total of 158 surveys was obtained. Most of the survey physicians were pediatricians (34%). Most of the survey physicians referred not knowing hydrogen breath tests (69%), have not indicated the breath tests (93%), and not knowing the cost (95,6%). 67,1% of the survey physicians described ignorance has the limiting factor for not indicating this kind of test in their practice. Physicians considered hydrogen breath test useful for the diagnosis of carbohydrates intolerance (38,6%), intestinal overgrowth bacterial syndrome (31,6%), and not useful (32,9%). Discussions : There is a considerable ignorance in the medical community about hydrogen breath test. Even further, this diagnostic resource is underutilized in our context. The results present the necessity to give more diffusion and to educate medical community about hydrogen breath tests.
RESUMO
BACKGROUND: Hydrogen breath tests (HBT) are used to confirm the diagnosis of carbohydrate intolerance or small intestinal bacterial overgrowth (SIBO). OBJECTIVE: Determine the existence of a correlation between the presence and intensity of symptoms experimented by the patient after the ingestion of a carbohydrate load and the test result. MATERIALS AND METHODS: This is an observational, retrospective and analytic study, in which all patients' files from year 2008 to 2014 containing a report of a HBT performed at Hospital San José TEC de Monterrey were revised. Using a visual analogue scale (VAS), the patient reported the intensity of gastrointestinal symptoms during the test. Descriptive statistics were obtained, and exclusively for lactose HBTs, Pearson's correlation coefficient (r) between maximum hydrogen concentration in breath and symptom intensity was calculated. RESULTS: A HBT was performed in 33 patients: 23 with lactose, 5 with fructose, and 5 with lactulose as substrate. Of these, 10, 2, and 5 tests were positive, respectively. For lactose HBTs, the symptom with most sensitivity was flatulence (80%), which also had the greatest likelihood ratio for a positive test (1.73). Diarrhea had the greatest specificity (84.6%). A tendency for positivity was observed when patients presented symptoms. A moderately positive correlation between hydrogen ppm and symptom intensity was found (r=0.427, p=0.023). CONCLUSIONS: A correlation between symptom intensity and test positivity was found in patients with lactose intolerance. The presence of flatulence after lactose loading may be indicative of a positive test.