D-xylose absorption

The test requires a blood and urine sample. For information on how these samples are obtained, see:

• Clean catch urine specimen
• Venipuncture (blood draw)

There are several ways to perform this test. A typical procedure is described below, but make sure you follow the specific instructions you are given.

You will be asked to drink 8 ounces of water that contains 25 grams of a sugar called d-xylose. The amount of d-xylose that comes out in your urine over the next 5 hours will be measured. You may have a blood sample collected at 1 and 3 hours after drinking the liquid. The amount of urine you produce over a 5-hour period is also determined. Your health care provider will tell you how to collect all of the urine during a 5-hour period.

Do not eat or drink anything (even water) for 8 to 12 hours before the test. Do not exercise before the test. A failure to restrict activity may affect test results.

Your health care provider may tell you to stop taking certain drugs that can affect test results. Drugs that can affect test results include aspirin, atropine, indomethacin, isocarboxazid, and phenelzine. Never stop taking any medicine without first talking to your doctor.

When the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.

Urine is collected as part of normal urination with no discomfort.

Your doctor may order this test if you have:

• Persistent diarrhea
• Signs of malnutrition
• Unexplained weight loss

This test is primarily used to determine if nutrient absorption problems are due to a disease of the intestines.

A normal result depends on how much D-xylose is given. Usually the test results are either positive or negative. A positive result means that D-xylose is found in the blood or urine and is therefore being absorbed by the intestines.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

Lower than normal values may be seen in:

• Celiac disease (sprue)
• Crohn's disease
• Giardia lamblia infestation
• Hookworm infestation
• Lymphatic obstruction
• Radiation enteropathy
• Small intestinal bacterial overgrowth
• Viral gastroenteritis
• Whipple's disease

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Multiple tests may be necessary to determine the reason for malabsorption.

Xylose tolerance test

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 142.

Updated by: Chad Haldeman-Englert, MD, FACMG, Wake Forest School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.