Outcome of breath tests in adult patients with suspected small intestinal bacterial overgrowth.
Gastroenterology and Hepatology from Bed to Bench,
Vol. 10 No. 3 (2017),
5 Mordad 2017
,
Page 168-172
https://doi.org/10.22037/ghfbb.v0i0.1113
Abstract
Aim: The aim was to investigate breath test outcomes in patients with suspected SIBO and indicative symptoms of SIBO, diagnosed by breath testing.
Background: Breath testing is used to detect small intestinal bacterial overgrowth (SIBO) by measuring hydrogen and methane produced by intestinal bacteria.
Methods: This retrospective cross sectional study included 311 patients with gastrointestinal symptoms who underwent the breath test for evaluation of SIBO at Celiac Disease Center at Columbia University, New York, in 2014-2015. The patients were divided into two groups based on the physician’s choice: lactulose breath test group (72%) and glucose breath test group (28%). Among them, 38% had a history of celiac disease or non-celiac gluten sensitivity.
Results: In total, 46% had a positive breath test: 18% were positive for methane, 24 % positive for hydrogen and 4% positive for both gases (p=0.014). Also, 50% had a positive lactulose breath result and 37% had a positive glucose breath result (p=0.036). The most common symptom for performing the breath test was bloating and the only clinical symptom that significantly showed a positive glucose breath test was increased gas (p=0.028).
Conclusion: Lactulose breath test was more often positive than glucose breath test. Positivity for hydrogen was more common than methane. Bloating was the most frequently perceived symptom of the patients undergoing the breath test but the only statistically significant clinical symptom for a positive glucose breath test was increased gas. Furthermore, the results showed that there was no significant association between positive breath test result and gender, age, non-celiac gluten sensitivity or celiac disease.
Keywords: Small intestinal bacterial overgrowth, Lactulose breath test, Glucose breath test, Gastrointestinal symptoms, Adults.
- Small intestinal bacterial overgrowth
- Lactulose breath test
- Glucose breath test
- Gastrointestinal symptoms
- Adults.
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References
Quigley EM, Quera R. Small intestinal bacterial overgrowth: roles of antibiotics, prebiotics, and probiotics. Gastroenterology 2006 Feb;130(2 Suppl 1):S78-90.
Khoshini R, Dai SC, Lezcano S, Pimentel M. A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Dig Dis Sci 2008 Jun;53(6):1443-1454.
Bures J, Cyrany J, Kohoutova D, Forstl M, Rejchrt S, Kvetina J, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol 2010 Jun 28;16(24):2978-2990.
Bohm M, Siwiec RM, Wo JM. Diagnosis and management of small intestinal bacterial overgrowth. Nutr Clin Pract 2013 Jun;28(3):289-299.
Hellstrom P. Bakteriell överväxt. In: Nyhlin H, editor. Medicinska mag- och tarmsjukdomar. 1st ed. Helsingborg: Studentlitteratur; 2008. p. 333-336.
Siniewicz-Luzenczyk K, Bik-Gawin A, Zeman K, Bak-Romaniszyn L. Small intestinal bacterial overgrowth syndrome in children. Prz Gastroenterol 2015;10(1):28-32.
Miazga A, Osinski M, Cichy W, Zaba R. Current views on the etiopathogenesis, clinical manifestation, diagnostics, treatment and correlation with other nosological entities of SIBO. Adv Med Sci 2015 Mar;60(1):118-124.
Erdogan A, Rao SS, Gulley D, Jacobs C, Lee YY, Badger C. Small intestinal bacterial overgrowth: duodenal aspiration vs glucose breath test. Neurogastroenterol Motil 2015 Apr;27(4):481-489.
Gabrielli M, D'Angelo G, Di Rienzo T, Scarpellini E, Ojetti V. Diagnosis of small intestinal bacterial overgrowth in the clinical practice. Eur Rev Med Pharmacol Sci 2013;17 Suppl 2:30-35.
Sachdev AH, Pimentel M. Gastrointestinal bacterial overgrowth: pathogenesis and clinical significance. Ther Adv Chronic Dis 2013 Sep;4(5):223-231.
Gasbarrini A, Corazza GR, Gasbarrini G, Montalto M, Di Stefano M, Basilisco G, et al. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther 2009 Mar 30;29 Suppl 1:1-49.
Rana SV, Malik A. Hydrogen breath tests in gastrointestinal diseases. Indian J Clin Biochem 2014 Oct;29(4):398-405.
Braden B. Methods and functions: Breath tests. Best Pract Res Clin Gastroenterol 2009;23(3):337-352.
Ghoshal UC. How to interpret hydrogen breath tests. J Neurogastroenterol Motil 2011 Jul;17(3):312-317.
Vantrappen G, Janssens J, Hellemans J, Ghoos Y. The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest 1977 Jun;59(6):1158-1166.
Rana SV, Sharma S, Kaur J, Sinha SK, Singh K. Comparison of lactulose and glucose breath test for diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Digestion 2012;85(3):243-247.
Malik BA, Xie YY, Wine E, Huynh HQ. Diagnosis and pharmacological management of small intestinal bacterial overgrowth in children with intestinal failure. Can J Gastroenterol 2011 Jan;25(1):41-45.
Lee JM, Lee KM, Chung YY, Lee YW, Kim DB, Sung HJ, et al. Clinical significance of the glucose breath test in patients with inflammatory bowel disease. J Gastroenterol Hepatol 2015 Jun;30(6):990-994.
Schatz RA, Zhang Q, Lodhia N, Shuster J, Toskes PP, Moshiree B. Predisposing factors for positive D-Xylose breath test for evaluation of small intestinal bacterial overgrowth: a retrospective study of 932 patients. World J Gastroenterol 2015 Apr 21;21(15):4574-4582.
Reddymasu SC, Sostarich S, McCallum RW. Small intestinal bacterial overgrowth in irritable bowel syndrome: are there any predictors? BMC Gastroenterol 2010 Feb 22;10:23-230X-10-23.
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