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Commentary: sugar intolerances in functional gastrointestinal disorders – author’s reply

relating to a clinically relevantarea guided mainly by assumptions, intuition and anec-dotal evidence. Our study in over 1300 patients providesclear clinical guidance on the objectives set out in thepaper and not previously examined in association. Firstly,fructose and lactose intolerances are equally commonacross all major functional gastrointestinal disorders(FGIDs). Secondly, symptoms during breath testing, butnot malabsorption, correlate with the clinical symptomsof FGID. Thirdly, that FGID patients with intolerancesmore commonly have non-GI symptoms than patientswithout intolerances. Finally, that successful dietarysymptom relief is achieved in a majority of patients inde-pendent of the demonstration of malabsorption.Besides this clinically relevant information, modiﬁca-tions of the methodology of breath testing are recom-mended. We therefore disagree with Barrett andGibson’s viewpoint based largely on an emphasis of mal-absorption, that the study does not clarify the role ofbreath testing in clinical decision-making regardingpatients with FGIDs.The paper recommended and authored by Barrettet al. is undoubtedly important reading.