TRIOLEIN BREATH TEST - SENSITIVE AND SPECIFIC TEST FOR FAT MALABSORPTION

Abstract

To develop a simple and accurate screening test for steatorrhea, quantitative stool fat excretion was compared with breath excretion of 14CO2 after the ingestion of 14C-labeled trioctanoin, tripalmitin or triolein. The study group included 24 nonobese subjects without steatorrhea but with diarrhea secondary to irritable bowel syndrome and 40 subjects with steatorrhea. The triolein breath test provided the most reliable discrimination, with 100% sensitivity and 96% specificity. The trioctanoin and tripalmitin breath tests were sensitive, but lacked specificity. Of the 12 obese patients with irritable bowel syndrome 3 had false-positive triolein breath results. In detecting steatorrhea, the triolein breath test was moderately superior to the measurement of serum carotene and to qualitative stool fat. The triolein breath test appears to be a sensitive, specific, noninvasive and relatively simple screening test for the detection of steatorrhea.