World leaders in breath analysis are named finalists for the SEHTA innovation
category.

Bedfont® Scientific Limited are thrilled to have been selected as a finalist in the Innovation category
at the South East Health Technologies Alliance (SEHTA) Awards 2025. The SEHTA Awards celebrate
excellence in health technology innovation and acknowledge the outstanding collaborations among
industry, academia, and the NHS across the South East of England.

This recognition highlights Bedfont’s commitment to advancing innovation in breath analysis. With
over 48 years of knowledge and expertise in designing and manufacturing breath analysis devices,
Bedfont® has continued to improve its devices to keep up with technology and market trends, and
evolve and improve its internal company processes.

“We are incredibly honoured to be recognised as finalists in the SEHTA Awards 2025. This acknowledgement reinforces our dedication to pushing the boundaries of innovation and delivering transformative solutions in breath analysis,” said Jason Smith, CEO at Bedfont®. “We look forward to the awards ceremony and celebrating innovation alongside other industry leaders.”

The winners will be announced at the SEHTA Awards Ceremony, which will be held on Thursday, April
10th, at the London Institute for Healthcare Engineering. The evening will unite businesses to
showcase healthcare innovation and collaboration excellence contributions.


For more information on Bedfont® and how it revolutionises healthcare through breath analysis, visit
www.bedfont.com or follow @BedfontLtd on social media.

Bedfont® promotes movement in the workplace as part of a commitment to employee wellbeing.

Bedfont® Scientific Limited, an award-winning med-tech company in Harrietsham, Kent, was excited
to participate in the Joe Wicks Movement Hour on Wednesday 5th March. The Joe Wicks Movement
Hour aimed to promote physical activity and wellbeing within the workplace. The event encouraged
employers across the UK to allocate an hour during the working day for employees to engage in
physical activities.

Bedfont® is passionate about employee wellbeing and focuses heavily on a healthy work/life balance.
The Joe Wicks Movement Hour provided an extra opportunity to get staff moving and away from
their desks for a break.

Whether working remotely or in the office, staff were encouraged to use the hour to do a physical
activity of their choice. The suggested activities were taking a walk, going on a bike ride, taking the
children to the park, or joining the garden committee in the Bedfont® Wellbeing Garden to help tidy
up and prepare the space for Spring.


“We believe that a healthy workforce is a happy and productive workforce,” said Jason Smith, CEO at
Bedfont®. “Taking part in Joe Wicks’ Movement Hour is a fantastic way to reinforce our commitment
to employee wellbeing and encourage staff to be more active throughout the day.”


Last week, Jemma Carter, Communications and Content Coordinator at Bedfont® was invited to
speak on BBC Radio Kent to share insights on how Bedfont® is embracing the movement and the
positive impact it is expected to have on employees. The conversation highlighted the importance of
movement in the workplace and how small changes can improve overall health and morale.


With the success of the Joe Wicks Movement Hour, Bedfont® continues to prioritise health and
wellbeing in the workplace and plans to encourage staff to incorporate more movement into their
daily routine.


For more information on Bedfont® and its wellbeing initiatives, follow @BedfontLtd on social media
or visit www.bedfont.com.

National No Smoking Day is observed in the UK annually on the second Wednesday of March, falling on the 12th of March 2025. Inaugurated on Ash Wednesday in 1984, the day aims to raise awareness of the dangers of smoking and encourage smokers to quit, highlighting the benefits of a smoke-free life.

Smoking poses serious health risks, affecting nearly every organ in the body. Smokers significantly increase the risk of developing Chronic Obstructive Pulmonary Disease (COPD) and lung cancer, as well as heart disease.

The good news is quitting smoking brings immediate and long-term health benefits, reducing health risks and improving overall well-being. The thought of quitting smoking can be a daunting one, but with the right tools and support, a quit attempt is more likely to be successful and doesn’t have to be stressful.

Why quit smoking?

Carbon monoxide (CO) is a harmful gas found in cigarette smoke. When inhaled, CO is absorbed into the bloodstream, reducing oxygen levels and increasing the risk of heart disease. Improvements can be seen in as little as 8 hours after smoking the last cigarette.

  • After 8 hours oxygen levels will start to recover, and the CO levels in the bloodstream will have reduced by half1.
  • After 48 hours, the CO levels will have dropped to those of a non-smoker1.
  • After two weeks to three months, your lung function and circulation improve2.
  • After nine months, coughs and shortness of breath decrease and your lungs are recovering2.
  • After one year, your risk of coronary heart disease is halved2.
  • After five years, your risk of many types of cancer is reduced2.

Smoking doesn’t only impact health; it can significantly impact finances as well. it is thought if you smoke the average amount of cigarettes a day (11.1), you could save £1,239 after six months2, based on the cheapest pack of cigarettes.

Healthcare Impact

Smoking also places a significant burden on the NHS; with more GP visits and health complications due to smoking, resources are stretched. It is thought that ending smoking could free up 75,000 GP appointments each month3, which would allow healthcare professionals to focus on preventative care and other critical issues.

UK ‘Smokefree’ by 2030

In 2019, the UK government outlined its ambitious goal of making England ‘Smokefree’ by 2030, aiming to reduce adult smoking rates to 5% or less4. This initiative, part of a broader strategy for proactive, predictive, and personalised prevention5, also includes plans to gradually raise the legal smoking age, preventing anyone born after 2008 from ever legally purchasing tobacco. In line with these efforts, the government announced in January 2024 further measures to protect public health, particularly among young people. By the end of 2025, disposable vapes will be banned to curb their accessibility to children, alongside new regulations introducing plain packaging and restrictions on sweet-flavoured vapes, which are particularly appealing to younger audiences. These steps aim to tackle both smoking and vaping rates, moving closer to a smokefree future.

What help is available?

Quitting smoking isn’t always easy; there are many resources available to aid smoking cessation, from support groups to stop-smoking clinics. Here are a few available options:

NHS Stop Smoking Services

  • The NHS Smokefree service offers free expert support, advice, and resources.
  • Local Stop Smoking Clinics provide personalised quit plans and access to medications.

Nicotine Replacement Therapy (NRT)

  • Products like nicotine patches, gum, lozenges, nasal sprays, and inhalers help reduce withdrawal symptoms.
  • Available on prescription or over the counter, NRT provides a controlled dose of nicotine without the harmful chemicals in cigarettes.

CO Devices

  • CO devices provide real-time feedback on CO levels in exhaled breath.
  • Research has shown that smokers find CO devices helpful and help reduce their cigarette consumption, giving them the motivation to quit.

The Smokerlyzer®

The Smokerlyzer® is a range of CO devices that measure the amount of CO in a person’s exhaled breath, indicating their smoking status. By providing real-time CO readings, people can measure their progress during a quit attempt with the Smokerlyzer®. By providing instant feedback, detecting relapses, and reinforcing progress, the Smokerlyzer® makes quitting smoking more structured, motivating, and achievable.

The iCOquit® Smokerlyzer® is a remote Bluetooth® device that allows users to track their smoking cessation efforts from the comfort of their own homes. The device can be used with the iCOquit® app, available on Google Play and Apple App Store. Users can track their CO levels remotely and share results with smoking cessation advisors, friends, and family. This provides visual motivation and allows users to track their quitting progress in real time.

How National No Smoking Day Inspires Smoking Cessation

National No Smoking Day serves as a motivational push for many smokers to quit. With widespread support from health organisations, charities, and public health campaigns, it has helped thousands of people take their first step towards quitting.

With smoking still one of the leading causes of preventable illness and death in the UK6, it is clear that more needs to be done to educate and assist smokers on their quit-smoking journey. For more information on the Smokerlyzer® range and how it can aid in smoking cessation, please visit our website.

For more information on the impact of smoking across the globe, read our article ‘World No Tobacco Day 2024: How the Smokerlyzer® range can help.

References

  1. Make 2025 the year you quit smoking for good. [Internet]. NHS. [Cited Thursday 13th February 2025] Available from: https://www.nhs.uk/better-health/quit-smoking/#:~:text=After%2020%20minutes,halved%20compared%20with%20a%20smoker’s.
  2. No Smoking Day [Internet]. ASH Scotland. 2025. [Cited Tuesday 18th February 2025]. Available from: https://ashscotland.org.uk/no-smoking-day/
  3. Ending smoking could free up 75,000 GP appointments each month. [Internet]. Cancer Research UK. 2023. [Cited 7th January 2025]. Available from: https://news.cancerresearchuk.org/2023/03/07/ending-smoking-could-free-up-gp-appointments/
  4. The Smokefree 2030 ambition for England [Internet]. House of Commons Library. 2023. [Cited Tuesday 18th February 2025]. Available from: https://researchbriefings.files.parliament.uk/documents/CBP-9655/CBP-9655.pdf
  5. Advancing our health: prevention in the 2020s- consultation document [Internet]. GOV.UK. 2019. [Cited Tuesday 18th February 2025]. Available from: https://www.gov.uk/government/consultations/advancing-our-health-prevention-in-the-2020s/advancing-our-health-prevention-in-the-2020s-consultation-document
  6. House of Commons Library. Rachael Harker. [cited on Wednesday 19th February 2025] Available from https://commonslibrary.parliament.uk/research-briefings/cbp-7648/#:~:text=Smoking%20is%20a%20leading%20cause,adults%20aged%2035%20and%20over.

Hydrogen and methane breath testing (HMBT) is a non-invasive diagnostic tool frequently used to assess small intestinal bacterial overgrowth (SIBO) and carbohydrate malabsorption disorders such as lactose and fructose intolerance. Despite its widespread use in adults, its application in children is less standardized, and clinicians often face uncertainties about adapting adult protocols for the pediatric population.

This article discusses the use of HMBT in children, highlights the key considerations for interpreting results, and reflects on the most reliable available guidelines, particularly the 2017 North American Consensus.

Background and Current Challenges:

SIBO, as well as carbohydrate malabsorption such as lactose and fructose intolerance, can cause gastrointestinal symptoms in both children and adults, such as bloating, diarrhoea, abdominal pain, and malnutrition. In children, nutritional deficiencies leading to failure to thrive pose a great challenge in paediatric clinics. Since children require a constant supply of nutrients for healthy growth, accurate diagnosis is especially crucial in this age group. Despite the seriousness of the need for HMBTs in children, the literature is extremely sparse for this age group, and testing clinics have to rely on the more robust adult consensus guidelines. When applying adult HMBT protocols to children, there are significant challenges due to differences in gut physiology, metabolic rates, and transit times.

While the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) has issued guidelines for paediatric breath testing, there are limitations, including inconsistencies in test performance, lack of paediatric-specific threshold values, and variability in interpreting test results. This has led to hesitancy in fully endorsing these guidelines for clinical use. Instead, many experts, including myself, recommend following the 2017 North American Consensus guidelines, even though these were primarily designed for adults. The North American Consensus offers more robust guidance that can be adapted for paediatric use with careful consideration.

Test Protocols and Dosages for Children:

Despite the absence of paediatric-specific guidelines, one of the most reliable approaches is to use the same substrates and dosages as those recommended for adults. For instance, the North American Consensus suggests using:

  • Lactulose: 10 g or 15 mL for diagnosing SIBO.
  • Lactose or fructose: 25 g for diagnosing intolerance.

It is important to note that while these dosages are appropriate for adults, they may be on the higher side for children. For example, a 25 g dose of lactose is roughly equivalent to consuming 500 mL of milk, which can be excessive for a child and may lead to false positives. Therefore, clinicians should be cautious in interpreting positive results and should always consider the child’s ability to absorb such quantities.

Moreover, similar to adults, for children, it is particularly important to prioritise ruling out SIBO before testing for intolerance. SIBO can cause secondary malabsorption and intolerance, meaning that treating SIBO could resolve carbohydrate intolerance symptoms. This is of utmost importance in the paediatric age group, as diagnosing lactose intolerance entails significant restrictions on the essential nutrients required for the healthy growth of children.

SIBO Testing and the Role of Methane:

When testing for SIBO, lactulose is typically used as the substrate. Lactulose is a non-absorbable sugar, and the bacteria in the small intestine ferment it, producing hydrogen (H2) and methane (CH4). The consensus suggests using a 20 ppm rise in H2 from the baseline as the threshold for diagnosing SIBO. While this threshold was established for adults, it is also a conservative measure that can be applied to paediatric populations. It is conservative in the sense that if the test is negative for SIBO, despite the intake of adult-dose lactulose, SIBO is ruled out. A positive result for SIBO in children may be due to a quick oro-caecal transit, due to the shorter length of the GI tract or faster gut motility. Therefore, a positive result is inconclusive unless a paediatric oro-caecal transit study confirms the timing of lactulose transit in that particular patient for interpretation.

Methane Detection in Children: Thresholds, Prevalence, and Clinical Implications:

CH4 detection is an essential aspect of HMBT, particularly for identifying intestinal methanogen overgrowth (IMO). CH4 production has been linked to slower gastrointestinal motility, contributing to symptoms such as constipation, a common issue in children with IMO. Elevated CH4 levels not only indicate the presence of methanogenic flora but also highlight the need for targeted therapies that can alleviate gastrointestinal symptoms like bloating, abdominal discomfort, and malabsorption, particularly in children where growth and nutrient absorption are crucial.

One significant factor in interpreting CH4 breath test results in children is the role of oro-caecal transit time, which does not appear to impact CH4 analysis. Unlike H2 production, which can be influenced by rapid oro-caecal transit, CH4 detection is independent of how quickly food passes through the small intestine. This means that CH4 breath test results are less prone to false positives or negatives caused by variations in gut transit time, making them a reliable tool in both adult and paediatric populations.

However, when discussing CH4 thresholds, it is important to acknowledge the difference in the prevalence of methanogens between children and adults. Studies, including one by Vanderhaeghen et al. (2015), have shown that children generally have a lower prevalence of methanogens such as Methanobrevibacter smithii. In their study, 65% of children had detectable levels of methanogens, compared to 89% of adults, and the relative abundance of methanogens in children was lower (0.15% vs. 0.52%).

While the prevalence of methanogens is lower in children, this does not necessarily imply that CH4 production is consistently low in those who carry methanogens. Children with detectable methanogens may still produce CH4 at levels comparable to adults, as the metabolic activity of Methanobrevibacter smithii and related species is primarily driven by substrate availability rather than just the prevalence of the species. This means that while fewer children may test positive for CH4, those who do could produce significant amounts of CH4. However, the same article provides a very interesting insight into the relative abundance of Methanobacteriales in children that was significantly lower compared to adults (0.15% in children vs 0.52% in adults). This difference indicates that children who are positive for hosting methanogenic species may naturally produce less CH4, and using adult thresholds might lead to underdiagnosis. Therefore, using the 10 ppm threshold for CH4 in children could be considered a conservative measure, ensuring that cases of methanogen overgrowth are not over-diagnosed with the adult threshold for CH4 production.

Given this data, it seems prudent to maintain the adult threshold of 10 ppm for CH4 in children. This threshold is less prone to false positives in children. A positive result in children can be confidently interpreted as evidence of CH4 overproduction and potentially linked to conditions like IMO. However, a negative result may still leave some uncertainty, as the lower prevalence of methanogens in children might mean that the absence of detectable CH4 does not entirely rule out the possibility of overgrowth in a child with low but metabolically active methanogenic populations.

Lactose and Fructose Intolerance Testing:

Once SIBO or IMO has been ruled out, testing for lactose and fructose intolerance can proceed. The same substrates used in adult testing—25 g of lactose or fructose—may be used in children. Nevertheless, because of shorter oro-caecal transit times in children, there is a greater chance of obtaining false-positive results.

Clinicians should be mindful of the fact that a 25 g dose of lactose or fructose might exceed the typical absorption capacity for a child. This also could lead to false-positive test results that do not necessarily reflect the child’s usual dietary intake, which may only involve smaller quantities of these sugars.

A negative result is generally more reliable despite the intake of a high adult dose of substrates and the increased chance of quick oro-caecal transit or reduced absorption capacity in children.

Oro-Caecal Transit Time and Confirmation of Results:

One of the complexities in interpreting breath test results, especially in children, is determining whether a rise in H2 or CH4 is truly indicative of SIBO or simply reflects normal oro-caecal transit.
Scintigraphy can be used to confirm the oro-caecal transit time, and clinicians should ensure that the time to reach the caecum matches the expected timing seen in the breath test. This step can help prevent false positives and improve the accuracy of the diagnosis.

Limitations of Alternative Tests for Lactose Intolerance Compared to HMBT:

Another alternative way to test lactose intolerance is genetic testing (LCT gene), some clinicians may consider an LCT gene or intestinal biopsy for lactose intolerance. While genetic testing can be useful, particularly for identifying congenital lactase deficiency (CLD), it has limitations. Acquired lactose intolerance, which is the most common form, is not uniformly detectable through genetic testing because lactase production can vary along the intestinal lining. A biopsy, similarly, may yield false-negative or false-positive results depending on where the sample is taken. LCT has no value in monitoring response to treatment or dietary changes. It is also important to note that not all individuals with a positive LCT test are intolerant to lactose in real life.

An alternative diagnostic method is the lactose tolerance test (LTT), which involves measuring blood glucose levels after lactose ingestion. If lactose is properly digested, blood glucose levels should rise. However, this test has not been standardised for children, and there is considerable variability in how it is performed and interpreted, making it less reliable than breath testing in paediatric populations.

HMBT offers several advantages over these methods. Breath testing provides a non-invasive way to directly measure the presence of H2 and CH4 gases produced by the fermentation of undigested lactose in the colon. This method is particularly effective because it can detect lactose malabsorption regardless of its cause, whether congenital or acquired. Additionally, breath testing allows for monitoring of response to treatment or dietary changes, offering a more comprehensive approach to managing lactose intolerance.

Conclusion and Future Directions:

HMBT remains one of the most reliable diagnostic tools for assessing SIBO and carbohydrate malabsorption. While there is no definitive paediatric protocol, the North American Consensus guidelines provide a solid foundation for adapting adult protocols to younger patients.
Clinicians should exercise caution when interpreting positive results, especially in cases where substrate doses may be too high for children or where faster oro-caecal transit times could result in false positives. In all cases, ruling out SIBO or IMO should be the first step, as treating these underlying conditions can often resolve symptoms of intolerance.

HMBT remains the most practical approach for diagnosing SIBO and carbohydrate malabsorption in paediatric patients. However, more research is needed to refine protocols, establish paediatric-specific thresholds, and improve the accuracy of testing and interpretation in this vulnerable population.

HMBT with the Gastrolyzer® range:

For over 48 years, Bedfont® Scientific Limited has specialised in designing and manufacturing breath analysis medical devices. Using innovative technology, it provides cutting-edge solutions at affordable prices to improve accessibility and healthcare standards worldwide. Bedfont® produces the Gastrolyzer® range of non-invasive breath testers that help detect gastrointestinal disorders, one breath at a time. This range includes the Gastro+™, which measures H₂, and the GastroCH₄ECK®, which measures H₂, CH₄, and O₂, delivering instant results, recorded in parts per million (ppm).

Visit https://www.gastrolyzer.com/ to learn how to support your patients with the HMBT devices from Bedfont® Scientific Limited.

References:

  • Rezaie, A., et al. (2017). ”Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus.” American Journal of Gastroenterology, 112(5), 775-784.
  • Di Lorenzo, C., et al. (2019). ”Gastrointestinal Motility in Children.” Journal of Pediatric Gastroenterology and Nutrition, 68(6), 759-770.
  • Furnari, M., et al. (2018). ”Breath Tests for Small Intestinal Bacterial Overgrowth: A Comprehensive Review.” Gut and Liver, 12(4), 403-412.
  • He, T., et al. (2017). ”Lactose Intolerance and Genetic Testing: An Overview.” European Journal of Pediatrics, 176(8), 1113-1121.
  • Szajewska, H., et al. (2018). ”Lactose Intolerance in Children: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN).” Journal of Pediatric Gastroenterology and Nutrition, 66(1), 165-174.
  • Vanderhaeghen, S., Lacroix, C., & Schwab, C. (2015). ”Methanogen communities in stools of humans of different age and health status and co-occurrence with bacteria.” FEMS Microbiology Letters, 362(13), fnv092.
  • Ghali, M. B., et al. (2017). ”Gut methanogens: Methanobrevibacter smithii and health in children and adults.” Journals of Microbiology.
  • Nature Reviews Microbiology. (2017). ”The gut microbiome and its role in health and disease”.

Bedfont® Scientific Limited partners with Selig De Colombia to bring the Gastrolyzer® range of HMBT devices to Colombia.

Bedfont® Scientific Limited, word leaders in breath analysis with over 48 years of knowledge and expertise in designing and manufacturing innovative medical breath analysis devices, are thrilled to have joined forces with Selig De Colombia. Specialising in nuclear medicine, medical devices and disinfection technologies, Selig De Colombia successfully completed registration for the Gastrolyzer® range of hydrogen and methane breath test (HMBT) devices in November 2024.

The Gastrolyzer® HMBT devices aid in the diagnosis of various gastrointestinal (GI) disorders, such as small intestinal bacterial overgrowth (SIBO) and carbohydrate malabsorption. Hydrogen and Methane are gases produced when undigested carbohydrates are fermented in the gut; high levels of these gases can indicate potential GI disorders.

Jason Smith, CEO at Bedfont®, comments, “We are thrilled with the registration of the Gastrolyzer® range. The partnership with Selig De Colombia represents a significant milestone in our commitment to delivering innovative, high-quality solutions to the healthcare industry worldwide. Collaborating with a trusted leader like Selig De Colombia ultimately improves patient outcomes in Colombia.”

With it’s strong commitment to providing healthcare professionals with the highest-quality technology and customer service, Selig De Colombia aligns perfectly with Bedfont’s core values, making it a perfect choice for becoming a distributor in the Colombia region.

With the first shipment delivered in January, the partnership advances Bedfont’s vision of a world where everyone can access instant, non-invasive, simple breath testing to aid medical diagnosis. To find out more about HBMT testing with the Gastrolyzer® range, read our latest article, ‘Importance of Quality Control in Hydrogen Methane Breath Testing’ by Dr Jafar Jafari, director of GI Cognition and Head of Upper GI Physiology at the Guys and St Thomas’ Hospital.

For more information on Bedfont® breath analysis devices, please visit our website by clicking here.

In November 2024, the British Thoracic Society (BTS), Scottish Intercollegiate Guidelines Network (SIGN), and the National Institute of Care Excellence (NICE) asthma guidelines1 were released superseding the previously separate guidelines from BTS/SIGN2 and NICE3. The new joint guideline, based on current clinical evidence and cost-effective modelling, clears up the previous uncertainty about the diagnosis and routine management of asthma. This resource will help understand where Fractional exhaled Nitric Oxide (FeNO) is recommended and how, by following the guidelines, there is potential income for the practice.

What does FeNO measure?

FeNO is a measurement of exhaled nitric oxide. This is normal in exhaled breath as a part of the respiratory process but is raised in the presence of eosinophilic airway inflammation, which is present in the majority of people with uncontrolled asthma symptoms. Patients at presentation are likely to have a raised FeNO level if they are not taking inhaled steroid treatment, even if they are asymptomatic on the day of testing.

What do the new guidelines say?

In adults, the guidelines recommend either blood eosinophils or FeNO as the immediate test. FeNO has the advantage of an instant result reducing the need for a second consultation to review the results. Blood eosinophils are a systemic marker so can be influenced by medication or other illnesses.

The new joint guideline states that if the FeNO result is raised above 50 ppb, and supports the clinical history and examination of the patient, no further testing is required – this is adequate to diagnose asthma. If the result is less than 50ppb but the history and examination indicate asthma as a likely diagnosis, then further testing will be required (spirometry with bronchodilator reversibility, peak flow diary charting in the absence or delay in accessing spirometry availability). If both FeNO and spirometry do not confirm the diagnosis the patient will require referral for bronchial challenge testing.

In children the first-line recommended objective test to support a diagnosis of asthma in a child with a history suggestive of asthma is FeNO – there is no alternative first-line test recommended so primary care must have access to FeNO testing for all children presenting without delay.  The diagnostic level in children is 35 ppb. Again, if FeNO is raised, there is no need for further testing and a diagnosis can be made. If the FeNO result is below 35 ppb then spirometry with reversibility should be performed, or in the absence or delay in accessing spirometry a peak flow diary chart can be substituted. If spirometry also does not confirm asthma, the child will need either skin prick testing for house dust mite, or blood tests for eosinophils and total IgE. Blood tests are further along the diagnostic algorithm as it is less acceptable to children and parents.

The joint guidelines now recommend FeNO testing in certain areas of ongoing management. FeNO is recommended at routine review and before increasing medication, and specifically, once a patient is on a moderate dose Maintenance and Reliever Therapy (MART) regime, but still symptomatic to guide the need for specialist referral for consideration of biologics or increased non-steroid medication.

Using FeNO – benefits to practices

Time is a precious commodity in primary care. Access to FeNO testing to confirm a diagnosis of asthma has the potential for diagnosis to be made in a single visit as test results are instantly available. Different models of testing work well. It may be that all clinicians can perform and code a FeNO test at initial consultation, start inhaled therapy, and then review with the appropriate in-house asthma specialist where steroid naive results and response to treatment can be reviewed.

In England, practices strive to accomplish maximal Quality and Outcomes Framework (QoF)4 points to maintain practice income and fund expenses such as purchase and maintenance of equipment for example, FeNO devices. Currently, the QoF requirement for diagnosis of asthma is spirometry and one other test such as FeNO, bronchodilator reversibility or measures of variability. With the change in the BTS/SIGN/NICE guideline this will change in line with the guideline recommendations with the requirement that practices perform at least one objective test that indicates asthma. In adults initially, this could be FeNO or blood eosinophils, in children the initial test must be FeNO.

QoF points and payments

The QoF section for asthma diagnosis currently offers a maximum of 15 points. To achieve this the practice must hold an asthma register which is based on SNOMED coding- a structured clinical vocabulary for use in an electronic health record, and must have performed (and coded) the appropriate objective tests to confirm diagnosis. The practice does not need to achieve 100% to receive maximal payment.

One point in the QoF framework payment currently earns the practice £220.62 therefore if a practice successfully achieves maximal points the payment for this indicator for a year is 15 points at £220.62 totalling £3309.30 annually.

In some areas, additional payments might be achieved from locally agreed arrangements such as local enhanced service agreements.

NObreath® FeNO Device

The NObreath® FeNO device offers a significant advantage in aiding asthma diagnosis and management. The NObreath® is a non-invasive and easy-to-use tool that provides instant results, streamlining the process for patients and healthcare providers. Compared to other QoF-recommended tests, such as the bronchodilator reversibility test, which can take up to an hour, a FeNO test saves valuable time. By providing immediate results, the NObreath® supports efficient clinical decision-making, enhances patient experience, and helps practices meet QoF requirements effectively and effortlessly.

Disclaimer

All costs and figures mentioned in this article were accurate at the time of publication. Prices and other financial details are subject to change and may vary over time. We recommend checking with the relevant sources for the most up-to-date information

References:

  1. National Institute for Health and Care Excellence (2024) Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) NG 245 Available from https://www.nice.org.uk/guidance/ng245/chapter/Recommendations#principles-of-pharmacological-treatment [Last accessed 2.1.25]
  2. British Thoracic Society/Scottish Intercollegiate Guideline Network (2019) Guideline for the management of asthma. Available from https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/ [Last accessed 2/1/25]
  3. National Institute for Health and Care Excellence (2017) Asthma NG 80. Archived and replaced by NG 245
  4. NHS England (2024) Quality and Outcomes Framework Guidance for 24/25 Available from https://www.england.nhs.uk/wp-content/uploads/2024/03/PRN01104-Quality-and-outcomes-framework-guidance-for-2024-25.pdf [Last accessed 2.1.25]

Following a summer of community engagement in the Shaun in the Heart of Kent art trail; Bedfont® awards a prize for finding ‘Shorn the Return’.

Bedfont® Scientific Ltd., a world leader in breath analysis with over 47 years of expertise in manufacturing medical breath analysis devices, teamed up with Heart of Kent Hospice this summer as a sponsor of a Shaun the Sheep sculpture in the hugely successful Shaun in the Heart of Kent art trail. The trail, held in Maidstone, saw thousands of people take part, following the route in and around the Maidstone area.

The Bedfont® sponsored sheep ‘Shorn the Return’ was located by the Old Boat Café on the River Medway. Using the Shaun in the Heart of Kent app, users could collect the various sculptures by entering a unique code found on each sculpture; each collection allowed users to enter a prize draw to bag a freebie. ‘Shorn the Return’ was collected an amazing 4,920 times. Partnering with NewMed Limited, Bedfont® offered the lucky participants a chance to bag themselves a CELLER8® Pulsed Electromagnetic Field (PEMF) therapy device.

The CELLER8® is an easy-to-use, portable device which uses electromagnetic fields to promote healing processes in the body, which when used at different frequencies can stimulate and encourage your body’s natural recovery process. PEMF can be used to help relaxation, enhance energy levels, support health and wellness and improve sleep. The CELLER8® is a device manufactured by Bedfont® and sold exclusively through NewMed Limited, which has extensive knowledge and expertise in PEMF therapy.

Jason Smith, CEO at Bedfont® Scientific Ltd. commented “We are delighted to have been part of such a meaningful initiative, sponsoring a sculpture for the Shaun in the Heart of Kent trail. Supporting Heart of Kent Hospice in this creative and engaging project was truly inspiring, and seeing the community come together for such a great cause has been heartwarming. We are thrilled to gift a CELLER8® device to a participant with the help of NewMed.”

On Thursday 14th November, the lucky recipient visited Bedfont® HQ to pick up her CELLER8® device after finding the ‘Shorn the Return’ sculpture in the summer trail. She was overcome with emotion when she was told the CELLER8® was hers.

She expressed that after researching the CELLER8®, she is very excited to begin using PEMF consistently.

The NewMed team were on hand on the day to give a full and informative demonstration on how to use the device, explaining what settings would best benefit her.

Andy Smith, CEO and Founder at NewMed Ltd says “Supporting community initiatives like the Shaun the Sheep Trail means a lot to us at NewMed. Partnering with Bedfont® and the Heart of Kent Hospice allows us to bring the benefits of CELLER8® PEMF therapy to a wider audience.”

With the trail now complete, Bedfont® will continue to support Heart of Kent Hospice through various initiatives and events. To keep up to date with fundraising efforts for the hospice, follow @BedfontLtd on social media. To find out more about Bedfont®, please visit www.bedfont.com.

To find out more about how CELLER8® can help you, please visit www.celler8.com or follow celler8_ on Instagram.

Double Victory for Bedfont®: Crowned ‘Medium Business of the Year 2024 and ‘Best of Kent’.

Bedfont®, located in Harrietsham, Kent, has over 48 years of expertise in designing and manufacturing medical breath analysis devices. Bedfont® was delighted to win Medium Business of the Year 2024 and Best of Kent at the Kent Business Awards. The event was held at the Mercure Maidstone Great Danes Hotel on Wednesday, December 4th, where businesses from across the region came together to celebrate this year’s outstanding achievements.

Bedfont® was recognised in the Medium Business category, celebrating the team’s hard work and commitment, sustainable growth, and commercial success. The recognition also highlights Bedfont’s positive and proactive approach to occupational health and wellbeing strategies.

The Bedfont® team was impressed by the amazing achievements of all nominees on the night. Facing tough competition, Bedfont® proudly triumphed as the Medium Business of the Year 2024. But the celebrations did not stop there – just after Bedfont® was crowned as Medium Business of the Year, they were announced winners of the final category, “Best of Kent.”

The Best of Kent category examined over 500 finalists in the Kent Business Awards, with Bedfont® emerging as the overall winner. This recognition highlights the company’s strong financial growth and contribution to changing lives through its innovative breath analysis devices.

Jason Smith, CEO at Bedfont® Scientific, comments, ”Winning the Medium Business of the Year and Best of Kent at the Kent Business Awards is a tremendous honour and a testament to the incredible efforts of our team. These awards highlight our commitment to excellence in business and our focus on creating a workplace where health and well-being thrive. We are proud to be recognised among many outstanding companies and congratulate all the finalists and winners. This achievement motivates us to continue positively impacting our employees, customers, and the wider community.”

These award wins mark a significant milestone for the business, highlighting its commitment to excellence in business performance and fostering a supporting workplace culture. For more information on Bedfont®, please visit http://www.bedfont.com or follow @BedfontLtd on social media.

Hydrogen-methane breath testing (HMBT) is a widely used, non-invasive method to diagnose conditions such as small intestinal bacterial overgrowth (SIBO) and carbohydrate malabsorption (e.g. lactose intolerance). The accuracy of HMBT results depends heavily on proper quality controls, accurate calibration, appropriate sample collection, and meticulous interpretation of results. This article explores these aspects to emphasise their significance in obtaining reliable and clinically meaningful results.

Introduction to HMBT

HMBT measures the amount of hydrogen (H2) and/ or methane (CH4) in the breath after ingesting specific carbohydrates. Under normal conditions, small amounts of H2 and/ or CH4 are produced in the large intestine. However, in cases of carbohydrate malabsorption or SIBO, undigested carbohydrates are fermented by bacteria in the small intestine (SIBO) or the large intestine (malabsorption), producing H2 and/ or CH4 that is absorbed into the bloodstream and exhaled in the breath. The GastroCH4ECK® HMBT device is one of two devices in the Gastrolyzer® range, manufactured by Bedfont® Scientific Limited. The GastroCH4ECK® offers non-invasive direct breath testing, providing instant results. Breath samples can be captured using a breath bag and analysed at a later time.

Quality Control in HMBT

Quality control is a critical component of any diagnostic test to ensure the accuracy, reliability, and reproducibility of the results. The effectiveness of HMBT relies heavily on stringent quality control measures. Inconsistencies or errors in any stage of the testing process can significantly impact the interpretation of results, potentially leading to misdiagnosis and inappropriate treatment. In HMBT, quality control involves several key processes.

Calibration of the HMBT device:

The HMBT device must be calibrated at intervals advised by the manufacturer using a known standard gas concentration to ensure it provides accurate readings. This involves running the standard gas through the device and adjusting the machine to match the known concentration. Zero calibration involves ensuring that the device reads zero when exposed to ambient air, as ambient air should ideally contain negligible H2. Accurate zero calibration ensures that any detected H2 is due to gastrointestinal fermentation and not background noise. Span calibration involves adjusting the device to read accurately at a higher concentration using a calibration gas with a known H2 and CH4 concentration. Regularly changing the filters in the breath device is necessary to maintain its accuracy and prevent contamination. A log for filter changes helps track when filters were last replaced and ensures that they are changed according to the manufacturer’s recommendations, thus maintaining the integrity of the samples.

Standard Operating Procedures (SOPs):

SOPs for HMBT should include detailed instructions for preparing the patient, conducting the test, and handling samples. Routine maintenance is crucial to prevent significant errors and variability in results. The GastroCH4ECK® must be calibrated before first use, after transportation, and once every 4 weeks. To ensure timely calibration, a reminder will be displayed on the screen during start-up. Bedfont® recommends that the GastroCH4ECK® should have an annual service to check sensors and components to ensure its longevity and accuracy. This maintenance includes a thorough inspection, cleaning, calibration, and replacement of worn-out parts. Keeping a log of annual maintenance activities helps track the condition of the device and ensures that it receives timely servicing, preventing unexpected malfunctions.

Unlike other HMBT devices that measure carbon dioxide (CO2), the GastroCH4ECK® measures oxygen (O2), which is a quality indicator for the breath sample1. The measurement of O2 is essential as it helps to ensure that the bacteria in the large intestine, rather than those in the mouth or stomach, are responsible for any gas production observed during the test.

The accuracy of the HMBT results relies on proper sample collection and patient preparation. Several factors must be considered to ensure valid results. Patients are advised to follow a specific diet for 24-48 hours before the test, avoiding high-fibre and fermented foods to prevent high baseline H2 and CH4. Fasting for at least 12 hours before the test is crucial to minimise these baseline levels and align with standardisation studies establishing normal ranges in a fasting state, ensuring predictable and stable intestinal motility.

Patients should always consult with a healthcare professional first, before stopping any medication to ensure proper preparation and guidance. Certain medications, such as antibiotics, probiotics, and laxatives, should be avoided as they can disrupt gut flora and affect H2 and CH4 production. However, patients on long-term use with unchanged symptoms may continue these medications unless instructed by a healthcare professional. On the day of the test, patients should avoid physical activity and remain seated to prevent accelerated gastrointestinal transit, which can affect timing and H2 and CH4 concentration. Additionally, patients should avoid sleeping, as it alters gastrointestinal motility and impacts test results.

The test will begin with a collection of a baseline breath sample to measure the H2 and CH4 levels before carbohydrate ingestion. Then the patient will ingest a specific carbohydrate (e.g. lactulose, glucose, or lactose). The choice of the substrate depends on the clinical question (e.g. lactulose for SIBO, lactose for lactose intolerance). The patient must consume the standardised amount of the test substrate dissolved in a specified amount of water, following international guidelines. Breath samples are then collected at regular intervals (e.g. every 15-20 minutes) for 2-3 hours post-ingestion. Consistent timing is essential to accurately capture the H2 and CH4 production curves.

Several factors can affect the accuracy of HMBT results. Patients must adhere to the dietary and fasting instructions; non-compliance can lead to high baseline H2 and CH4 levels. Proper calibration and maintenance of the HMBT device is essential, malfunctioning equipment can lead to inaccurate readings. To avoid interpretation variability in HMBTs, it is crucial to adhere to a single reference guideline for performance and analysis. Currently, the most credible guideline is the North American Consensus2. Using this guideline ensures standardised procedures and consistent interpretation of results, minimising discrepancies and enhancing the reliability of HMBTs.

Environmental Monitoring:

Each HMBT device manufacturer provides specific instructions regarding the storage and operational temperatures for their devices. It is crucial to adhere strictly to these temperature guidelines when conducting direct breath tests and calibrations. Failure to operate the device within the recommended temperature can potentially affect accuracy.

Conclusion

HMBT is a reliable and non-invasive diagnostic tool for conditions like SIBO and carbohydrate malabsorption, provided that stringent quality controls, accurate calibration, proper sample collection, and meticulous interpretation are in place. Adhering to these protocols ensures the accuracy and clinical utility of HMBT, ultimately leading to better patient outcomes.

By focusing on these aspects, healthcare providers can maximise the diagnostic potential of HMBT and provide effective, targeted treatments for patients with gastrointestinal disorders.

HMBT with the Gastrolyzer® range

Utilising reliable diagnostic tools such as HMBT offers precise insights into the underlying causes of gastrointestinal symptoms, enabling healthcare professionals to formulate effective and tailored treatment plans. Bedfont® Scientific Limited manufactures the Gastrolyzer® range of non-invasive breath testing devices that help to detect gastrointestinal disorders, one breath at a time. The Gastrolyzer® range includes the Gastro+™ which measures H2 and the GastroCH4ECK® device which measures H2, CH4, and O2. Both devices provide instant results, recorded in parts per million (ppm).

To learn more about how the Gastrolyzer® range can help support your patients with gastrointestinal disorders, visit https://www.gastrolyzer.com/

References:

  1. Lee SM, Falconer IH, Madden T, and Laidler PO. Characteristics of oxygen concentration and the role of correction factor in real-time GI breath test. BMJ Open Gastroenterology. 2021 Jun 1;8(1):e000640. DOI:10.1136/bmjgast-2021-000640.
  2. Rezaie A, Buresi M, Lembo A, Lin H, McCallum R, Rao S, Schmulson M, Valdovinos M, Zakko S, Pimentel M. Hydrogen and methane-based breath testing in gastrointestinal disorders: the North American consensus. Official journal of the American College of Gastroenterology| ACG. 2017 May 1;112(5):775-84. DOI: 10.1038/ajg.2017.46.

NObreath® FeNO device and Gastrolyzer® range of devices are now available across the Middle East.

Bedfont® Scientific Limited, a world leader in breath analysis with over 47 years of knowledge and expertise in designing and manufacturing medical breath analysis devices, has partnered with Tebaba Medical Services, a leading supplier of high-quality medical supplies for healthcare providers across Africa and the Middle East. The successful registration in October means Tebaba will distribute Bedfont’s cutting-edge technology to healthcare professionals in the region, aiding in diagnosing and managing respiratory and gastrointestinal conditions.

The NObreath® Fractional exhaled Nitric Oxide (FeNO) device is used to aid in the diagnosis and management of asthma by measuring the nitric oxide levels on exhaled breath. High levels of nitric oxide indicate airway inflammation, common in allergic asthma.

The Gastrolyzer® range of devices, comprising of the Gastro+™ which measures the amount of hydrogen and the GastroCH4ECK® which measures the amount of hydrogen and methane in the breath, which can indicate gastrointestinal (GI) disorders such as small intestinal bacterial overgrowth (SIBO) and carbohydrate malabsorption.

Tebaba Medical Services, a well-established leader in the Middle Eastern healthcare market, was selected as a distributor for its strong alignment with Bedfont’s core values. With a commitment to delivering high-quality medical devices and exceptional customer service, Tebaba Medical Services brings extensive regional expertise to this partnership. By working together, Bedfont® and Tebaba are advancing the availability of cutting-edge breath analysis technology across the Middle East.

Jason Smith, CEO at Bedfont®, comments, “We are excited about the registration, which will allow our cutting-edge technology to transform the impact on respiratory and gastrointestinal health across the Middle East, marking an important step in our vision where everyone has access to instant, non-invasive, simple breath testing to aid in medical diagnosis.”

The first shipment was delivered in November, marking the beginning of Bedfont’s long-term commitment to supporting healthcare providers in the region with reliable, innovative technology and paving the way for enhanced patient care.

For more information on Bedfont® breath analysis devices, please visit our website by clicking here.

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