Functional examinations help assess the functioning of the digestive tract, identify possible dysfunctions, and choose the most appropriate treatment. These non-invasive methods provide detailed insight into the physiology of the stomach and intestines, allowing timely detection and prevention of health problems.
Breath tests
Breath tests are a simple and effective method to diagnose digestive tract disorders such as lactose intolerance, bacterial overgrowth, and Helicobacter pylori infection. During the examination, the patient drinks a specific solution, after which the hydrogen or other gas content in the breath is analyzed, providing precise information about intestinal function.
H. pylori breath test (13C-urea)
The 13C breath test is a non-invasive diagnostic test used to detect the presence of Helicobacter pylori (H. pylori) bacteria in the stomach. H. pylori is a common bacterium that infects the stomach lining and can cause various gastrointestinal diseases, such as peptic ulcers and stomach cancer.
During the examination, the patient drinks a solution containing a small amount of 13C-labeled urea — a substance that H. pylori breaks down in the stomach. When urea is broken down, the bacteria release carbon dioxide (CO2), which is then absorbed into the bloodstream and exhaled in the breath. The breath is collected in a special container (bag) at various intervals, usually every 10–15 minutes.
The breath samples are then analyzed to detect the presence of 13C-labeled CO2, which indicates the presence of H. pylori in the stomach. The 13C breath test is a reliable and accurate method for diagnosing H. pylori infection and is considered safe and well tolerated.
The 13C breath test for detecting H. pylori usually takes about 30 minutes.
How to prepare?
Preparation for the 13C breath test to detect H. pylori may vary depending on the specific instructions given by your healthcare provider. Generally, the following preparations may be recommended:
Medications: certain medications, such as antibiotics and proton pump inhibitors (PPIs), should be discontinued before the test, as they can affect the accuracy of the test results.
Diet: you must not eat or drink (except plain water) for 6–8 hours before the test. It is recommended to avoid alcohol, caffeine, and acidic or spicy foods.
Additionally: avoid smoking for 6–8 hours before the test.
Be sure to inform your treating doctor and the examiner about any health conditions or medications you are taking, as they may affect the test results.
To ensure accurate results, it is important to follow all the specific instructions provided by your doctor.
Hydrogen breath test for lactose (milk sugar) intolerance
The hydrogen breath test is a diagnostic test used to detect lactose malabsorption (absorption).
During the examination, the patient is given a drink containing lactose, and the amount of hydrogen in the breath is measured over time. When lactose is not absorbed in the small intestine, it is fermented by bacteria in the large intestine, producing hydrogen and other gases, which are then absorbed into the bloodstream and exhaled through the lungs. If the hydrogen level in the breath rises above the normal range, it indicates that lactose has not been properly absorbed, and the patient may have lactose malabsorption. This test is commonly used to diagnose lactose intolerance — a condition in which the body cannot digest lactose due to a deficiency of lactase (the enzyme that breaks down lactose).
This examination usually takes about 2–3 hours.
How to prepare?
Avoid dairy products and high-fiber foods 24 hours before the examination.
Do not take certain medications, such as antibiotics and laxatives, 24 hours before the examination.
Do not eat for at least 12 hours before the examination.
Do not smoke or chew gum for at least 2 hours before the examination.
It is important to follow the specific instructions provided by your doctor.
Lactulose breath test for determining orocecal transit time
Oral-cecal transit time and intestinal dysbiosis diagnostics using the hydrogen lactulose breath test are used to measure the time it takes for food to travel through the digestive system from the mouth to the cecum (the first part of the large intestine) and to detect bacterial overgrowth in the small intestine.
During the examination, the patient consumes a lactulose solution, which is a type of sugar that is not digested by the body but instead passes through the digestive tract and is fermented by bacteria in the large intestine. When bacteria ferment lactulose, they produce gases such as hydrogen and methane, which are absorbed into the bloodstream and eventually exhaled through the lungs.
Hydrogen and methane levels in the patient’s breath are measured at specific intervals after consuming the lactulose solution. A delay in the appearance of hydrogen and methane in the breath may indicate slow transit time through the digestive system, while elevated levels of hydrogen or methane may suggest bacterial overgrowth in the small intestine.
The duration of the examination may vary, but it usually takes about 2–3 hours.
How to prepare?
Diet: follow a low-fiber diet for at least 24 hours before the test. Avoid foods high in fiber, such as fruits, vegetables, beans, whole grains, and nuts. Eat light meals the day before the examination.
Do not eat or drink (except plain water) for at least 12 hours before the examination.
Medications: avoid taking antibiotics, laxatives, probiotics, and any drugs that affect bowel motility or digestion for at least 2 weeks before the test. Consult your treating doctor before stopping any medications.
Avoid smoking and strenuous physical activity for at least 12 hours before the test.
It is important to follow the specific instructions provided by your treating healthcare provider regarding preparation for the hydrogen lactulose breath test, as they may vary depending on your individual situation.
Glucose breath test for detecting intestinal dysbiosis
Diagnosis of intestinal dysbiosis using the hydrogen glucose breath test is a non-invasive diagnostic method used to assess the function and composition of the gut microbiota in the large intestine. It involves drinking a glucose solution and measuring the level of hydrogen gas in the breath at regular intervals over several hours. The test detects the presence of hydrogen gas produced by bacteria in the large intestine as they break down glucose.
The test can be used to detect bacterial overgrowth in the small intestine, which may cause various gastrointestinal symptoms such as bloating, gas, diarrhea, and abdominal pain. It can also be used to assess the effectiveness of antibiotic therapy in eliminating harmful bacteria and restoring a healthy gut microbiota.
The hydrogen glucose breath test usually takes about 2–3 hours.
How to prepare?
Preparation for the hydrogen glucose breath test is similar to other hydrogen breath tests. Patients should avoid certain foods and medications for a specific period before the test, usually 24 to 48 hours. These include:
Avoid foods containing complex carbohydrates, such as beans, legumes, grains, fruits, and vegetables, for 24–48 hours before the examination. Do not consume dairy products (including milk, cheese, and yogurt). Avoid sugary and carbonated drinks.
Do not take antibiotics and certain other medications for 2 weeks before the examination. Consult your treating doctor regarding medication use.
Avoid smoking and alcohol consumption before the test.
Additional instructions may include not eating on the day of the examination and avoiding intense physical activity.
It is important to follow the specific instructions provided by your treating doctor.
Pancreatic lipase secretion breath test (13C mixed triglycerides)
The 13C mixed triglyceride test is a diagnostic procedure used to assess the pancreas’s ability to secrete lipase (an enzyme that helps digest fats). During the examination, the patient is given a small amount of a mixed triglyceride solution containing a stable carbon isotope (13C). Then, the presence of the 13C isotope in the patient’s breath is analyzed, indicating how well the triglyceride was digested and absorbed.
The test can be used to diagnose pancreatic insufficiency, a condition in which the pancreas does not produce enough lipase.
The 13C mixed triglyceride test usually takes about 4–5 hours.
How to prepare?
Preparation for the 13C mixed triglyceride test may vary depending on your doctor’s instructions. However, some general guidelines for test preparation include:
Inform your treating doctor and the examiner about any medications or dietary supplements you are taking, as they may affect the test results and require dosage adjustments.
Do not eat or drink anything (except plain water) for at least 8 hours before the test.
Refrain from smoking and strenuous physical activity for at least 24 hours before the test.
Avoid consuming foods high in fat or alcohol for at least 24 hours before the test.
Follow all additional instructions provided by your treating doctor, such as fasting for a longer period or discontinuing certain medications.
It is important to report any concerns or questions to ensure that the examination is conducted safely and accurately.
Functional examinations
Functional examinations, such as esophageal and anorectal manometry, as well as pH-metry, help assess muscle and nerve function in the digestive tract. They are essential for diagnosing swallowing disorders, reflux disease, or bowel dysfunction, providing an accurate clinical picture and appropriate treatment.
24-hour pH monitoring of the stomach and esophagus
Esophageal and/or gastric 24-hour pH monitoring is a diagnostic test used to measure the amount of acid reflux in the esophagus and/or stomach. During the procedure, a thin, flexible catheter with a sensor is inserted through the nose or mouth and positioned in the esophagus or stomach. This sensor is connected to a small recording device worn by the patient around the waist or in a pocket. The patient goes about their normal daily activities, including eating and sleeping, for 24 hours while the device records episodes of acid reflux. This test helps diagnose gastroesophageal reflux disease (GERD), assess its severity, and monitor the effectiveness of treatment.
The esophageal and/or gastric 24-hour pH monitoring test usually takes 24 hours.
How to prepare?
Do not eat or drink for at least 6 hours before the examination.
Discontinue certain medications that may affect test results (for example, acid suppressants or antacids).
Wear loose, comfortable clothing.
During the examination, follow your usual diet and daily activities (unless your treating physician has instructed otherwise).
Keep a diary of your symptoms and activities during the examination, including when you eat, sleep, exercise, and take medications.
During the examination, avoid certain activities that may interfere with the recording device’s function, such as swimming or taking a bath.
It is important to follow all special instructions provided by your attending physician and the examination specialist, as preparation and procedure may vary depending on your individual needs and medical history.
Esophageal manometry
Esophageal manometry is a medical procedure used to assess the function of the esophagus and the lower esophageal sphincter. During the procedure, a small flexible device (catheter) with pressure sensors is inserted through the nose and guided into the esophagus. The catheter measures pressure changes in the esophagus as the patient swallows. This test helps diagnose conditions such as achalasia, diffuse esophageal spasm, and other esophageal motility disorders.
Esophageal manometry usually takes about 30 minutes to one hour. However, the exact duration of the procedure can depend on the specific methods and equipment used, as well as individual factors such as the patient’s anatomy and ability to cooperate during the procedure.
How to prepare?
To prepare for esophageal manometry, some instructions must be followed:
Doctor consultation: consult your doctor about all your health conditions and any medications you are taking.
Diet: do not eat or drink, including water, for 6-8 hours before the examination.
Medication use: avoid medications that can affect the esophageal muscles, including muscle relaxants, for several days before the procedure.
Clothing: wear comfortable, loose-fitting clothing that allows easy access to the upper abdomen.
Transport: since sedation is often used during the procedure, you will need someone to take you home afterward.
Anorectal manometry
Anorectal manometry is a diagnostic test that measures the function of the anal sphincter muscles, rectum, and sensation in the rectum. It is used to diagnose conditions affecting bowel control, such as fecal incontinence, constipation, and pelvic floor disorders. During the procedure, a small device with sensors is inserted into the rectum, and the patient performs various tasks, such as squeezing and relaxing the anal sphincter muscles, to measure pressure and muscle and nerve function in the anus and rectal area.
Anorectal manometry usually takes about 30 to 45 minutes. However, the exact duration of the procedure may vary depending on individual factors and the specific techniques used by the examiner.
How to prepare?
Preparation for anorectal manometry may vary depending on your doctor’s instructions. However, some general tips for preparing for anorectal manometry are as follows:
Inform your treating physician and the examiner about all medications you are taking, including over-the-counter drugs, herbal supplements, and vitamins, as some medications may affect the test results.
Before the test, follow your doctor’s instructions regarding diet and medications. You may be asked to refrain from eating or drinking for a certain period before the examination.
Wear comfortable clothing, preferably loose pants or skirts, as you may need to undress from the waist down.
Be prepared for some discomfort during the procedure, but inform the specialist if you experience any significant pain or discomfort.
Arrive on time for the examination and be sure to ask any questions you have about the procedure beforehand.
Elptesti
- 13C urea breath test for H. pylori detection90.00 EUR
- Hydrogen breath test for lactose (milk sugar) intolerance81.00 EUR
- Lactulose breath test for determining orocecal transit time81.00 EUR
- Glucose breath test for detecting intestinal dysbiosis81.00 EUR
- 13C mixed triglyceride breath test for pancreatic lipase secretion165.00 EUR
Funkcionālie izmeklējumi
- 24-hour pH monitoring of the stomach and esophagus150.00 - 245.00 EUR
- Esophageal manometry96.00 - 180.00 EUR
- Anorectal manometry150.00 EUR
- Anorectal manometry and consultation with a proctologist190.00 EUR
- Surcharge for use of a probe (with balloon) to assess bowel sensitivity68.00 EUR
Prof. Mārcis Leja
gastroenterologs
GASTRO
Dr. Guntis Ancāns
ķirurgs - proktologs, ķirurgs - onkologs
GASTRO
Dr. Anna Marija Leščinska
ārste stažiere (rezidente ķirurģijā)
GASTRO