scholarly journals Small intestinal bacterial overgrowth is associated with intestinal inflammation in the irritable bowel syndrome

2014 ◽  
Vol 87 (3) ◽  
pp. 163-165 ◽  
Author(s):  
Liliana David ◽  
Alexandru Babin ◽  
Alina Picos ◽  
Dan Lucian Dumitrascu

Background and aim. Small intestinal bacterial overgrowth is encountered in bowel disorders, including irritable bowel symptoms. Low degrees of inflammation have been recently reported in the irritable bowel syndrome. We looked for the association between intestinal inflammation and small intestinal bacterial overgrowth in irritable bowel syndrome.Methods. Small intestinal bacterial overgrowth was assessed by the H2 glucose breath test in 90 consecutive patients with irritable bowel syndrome. A check-up of the oral cavity was carried out before the breath testing.  Further on, the patients were classified into two groups, positive and negative, at the breath test. Then they were tested for intestinal inflammation with a fecal test for calprotectin. We used a semiquantitative test for this study. Both groups were compared for the association of intestinal inflammation with small intestinal bacterial overgrowth.Results. A number of 24/90 (26.7%) patients with irritable bowel syndrome had small intestinal bacterial overgrowth. A positive test for intestinal inflammation was significantly more frequent in patients with irritable bowel syndrome and small intestinal bacterial overgrowth (chi2: p<0.05).Conclusions. Small intestinal bacterial overgrowth is present in almost one quarter of patients with irritable bowel syndrome. It is significantly associated with intestinal inflammation.

Author(s):  
LA Costa ◽  
TNF Gomes ◽  
CU Braga ◽  
L Lenz ◽  
SJ Miszputen ◽  
...  

Background: Irritable bowel syndrome (IBS) has been considered a functional disease, however evidences suggest organic abnormalities as disbiosis. The aim of this study was to evaluate bacterial overgrowth syndrome in IBS patients. Methods: Patients with IBS were submited to the expired H2 and CH4 breath test, with analyzes of exhaled air in fasting (zero minutes) and after the administration of 10g of lactulose, at times: 15, 30, 60, 90, 120, 150 and 180 minutes. The test was considered positive when the values of H2 or CH4 at 90 minutes were 20 ppm above baseline values. Results: Fourth-six patients were included, 23 (50%) had diarrheal subtype, 12 (26.1%) had constipated subtype and 11 (23.9%) had mixed subtype. All patients were submitted to lactulose breath test (LBT), with evaluation of expired H2 and CH4. The H2 test positivity was 15.2% and the CH4 test was 10.9%. In the diarrheal subgroup, the positivity of the H2 test was 13%, and at the CH4 test was 8.7%. Among the constipated patients, 16.7% were positive for H2 test, and none was positive for CH4 test. At the mixed subtype, the H2 test was positive for 18.2% and CH4 test for 27.3%. There was no significant correlation between the positivity of expired H2 test with the diarrheal subtype, and neither the expired CH4 test with the constipated subtype. Conclusion: LBT has not altered in patients with three forms of IBS. The optimization of diagnostic methods is necessary for a more accurate diagnosis.


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