Is the 14C-Triolein Breath Test Useful in the Assessment of Malabsorption in Clinical Practice?

Abstract

A ¹⁴C-triolein breath test was carried out on 49 subjects suffering from chronic pancreatitis or from other digestive diseases, and its results were compared with the daily fecal fat excretion. The ¹⁴CO₂ peak excretion was abnormal in all the subjects with a fecal fat excretion above 14 g/day, whereas individual values of ¹⁴CO₂ peak excretion in subjects without steatorrhea and with a fecal fat excretion ranging from 7.1 to 14 g overlapped. The lowest value observed in patients not suffering from steatorrhea was chosen as the lower normal limit of ¹⁴CO₂ peak excretion. A test sensitivity as high as 64% was attained. The correlation between fecal fat and ¹⁴CO₂ peak excretion was highly significant (r = 0.802; p < 0.0001), and it followed a negative exponential function. Therefore, small variations in the ¹⁴CO₂ peak excretion can be associated with a wide range of fecal fat excretion. Well-compensated diabetes secondary to pancreatitis did not interfere with the results of the test. In conclusion, in our experience this test proved to be a qualitative diagnostic tool with a low sensitivity.