Reduced ¹³C-d-xylose absorption in alcoholics is more likely caused by alterations in small intestinal mucosa than delayed gastric emptying

Abstract

Objective. Alterations of the small intestinal absorptive surface are a probable cause of d-xylose malabsorption in chronic alcoholism. Delayed gastric emptying, however, may influence the ¹³C-d-xylose breath test, which is used to study intestinal function in alcoholics. The aim of this study was to measure gastric emptying in alcoholics to elucidate whether retention of the test meal could explain the malabsorptive pattern of the ¹³C-d-xylose breath test observed in alcoholics. Material and methods. Fifteen alcoholics performed the ¹³C-octanoic acid and the ¹³C-d-xylose breath tests on consecutive days in a random order. The ¹³CO₂ expired was measured every 30 or 15 min for 4 h in the ¹³C-d-xylose and the ¹³C-octanoic acid breath tests, respectively, using a mass spectrometer equipped with a gas chromatograph. Test meals consisted of 100 mg of ¹³C-d-xylose and 5 g of unmarked d-xylose dissolved in 250 ml water and 91 mg ¹³C-octanoic acid embedded in a one-egg omelette served with white bread with margarine, respectively. Results. The alcoholic patients had a lower ¹³C-d-xylose breath index compared with healthy controls (p < 0.0001). None of the ¹³C-octanoic acid breath test variables, T_50%, T_max, T_lag, or GEC revealed any significant differences between the groups. Conclusion. The pathological ¹³C-d-xylose breath test in this group of alcoholics is unlikely to be caused by delayed gastric emptying. Malabsorption is the probable cause of the pathological ¹³C-d-xylose breath test results in alcoholics.

Key Words::

• ¹³C-d-xylose breath test
• ¹³C-octanoic acid breath test
• alcoholics
• gastric emptying
• malabsorption syndromes

Acknowledgments

H. B. Hope is supported by a grant from Eastern Norway Regional Health Authority. Clinical nutritionist Johanne Alhaug performed the patient interview for the food frequency questionnaire.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.