Small intestine bacterial overgrowth is frequent in cystic fibrosis: combined hydrogen and methane measurements are required for its detection.

Hydrogen breath test (BT) is commonly used as a diagnostic tool for the detection of small intestine bacterial overgrowth (SIBO). It was reported that colonic methane production is far more frequent in cystic fibrosis (CF) patients than in other subjects. Therefore, measuring exclusively hydrogen in the diagnostic breath test for diagnosing SIBO might be of limited value. We aimed to assess the usefulness of combined measurement of hydrogen and methane expiration for the diagnosis of SIBO in CF. The study comprised 62 CF patients aged 5 to 18 years. Three-hundred-ninety subjects assessed due to gastrointestinal symptoms for the presence of SIBO served as a comparative group. In all subjects hydrogen/methane BT using glucose was performed. A positive BT was defined as fasting hydrogen > or = 20 ppm or fasting methane > or = 10 ppm or a rise of > or = 12 ppm hydrogen or > or = 6 ppm methane over baseline during the test. In 23 (37.1%) CF patients and in 52 (13.3%) subjects from the comparative group abnormal BT results were found. In seven (11.3%) CF patients and 29 (7.4%) of the other subjects studied methane measurement allowed diagnosis of SIBO. Small intestine bacterial overgrowth is frequent in cystic fibrosis. For its detection in cystic fibrosis and other gastrointestinal patients, combined hydrogen and methane measurement instead of hydrogen breath test should be applied. Without the additional measurement of methane a significant percentage of SIBO will be missed.

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PTH-194 A Retrospective Analysis of Glucose-Hydrogen Breath test for Small Intestine Bacterial Overgrowth in a Teaching Hospital

Gut ◽

10.1136/gutjnl-2013-304907.681 ◽

2013 ◽

Vol 62 (Suppl 1) ◽

pp. A290.2-A291

Author(s):

S West ◽

A C Ford ◽

K Argyle ◽

D Hick ◽

J S Jennings

Keyword(s):

Small Intestine ◽

Retrospective Analysis ◽

Teaching Hospital ◽

Breath Test ◽

Bacterial Overgrowth ◽

Hydrogen Breath Test ◽

Small Intestine Bacterial Overgrowth

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PREVALENCE OF SMALL INTESTINE BACTERIAL OVERGROWTH IN PATIENTS WITH GASTROINTESTINAL SYMPTOMS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201700000-06 ◽

2017 ◽

Vol 54 (2) ◽

pp. 91-95 ◽

Cited By ~ 5

Author(s):

Carolina Piedade MARTINS ◽

Caio Henrique Amorim CHAVES ◽

Maurício Gustavo Bravim de CASTRO ◽

Isabel Cristina GOMES ◽

Maria do Carmo Friche PASSOS

Keyword(s):

Small Intestine ◽

Breath Test ◽

Gastrointestinal Symptoms ◽

Bacterial Overgrowth ◽

Bacterial Metabolism ◽

Breath Tests ◽

Small Intestine Bacterial Overgrowth ◽

Exhaled Air ◽

Gastrointestinal Complaints ◽

Number Of Individuals

ABSTRACT BACKGROUND Small intestine bacterial overgrowth is a heterogeneous syndrome characterized by an increase in the number and/or the presence of atypical microbiota in the small intestine. The symptoms of small intestine bacterial overgrowth are unspecific, encompassing abdominal pain/distension, diarrhea and flatulence. Due to the increased cost and complexity for carrying out the jejunal aspirate, the gold standard for diagnosis of the syndrome, routinely the hydrogen (H 2 ) breath test has been used, utilizing glucose or lactulose as substrate, which is able to determine, in the exhaled air, the H 2 concentration produced from the intestinal bacterial metabolism. However, due to a number of individuals presenting a methanogenic microbiota, which does not produce H 2 , the testing on devices capable of detecting, concurrently, the concentration of exhaled H 2 and methane (CH 4 ) is justified. OBJECTIVE This study aimed to determine the prevalence of small intestine bacterial overgrowth in patients with digestive symptoms, through a comparative analysis of breath tests of H 2 or H 2 and CH 4 associated, using glucose as substrate . METHODS A total of 200 patients of both sexes without age limitation were evaluated, being directed to a Breath Test Laboratory for performing the H 2 test (100 patients) and of exhaled H 2 and CH 4 (100 patients) due to gastrointestinal complaints, most of them patients with gastrointestinal functional disorders. RESULTS The results indicated a significant prevalence of small intestine bacterial overgrowth in the H 2 test and in the test of exhaled H 2 and CH 4 (56% and 64% respectively) in patients with gastrointestinal symptoms, and higher prevalence in females. It found further that methane gas was alone responsible for positivity in 18% of patients. CONCLUSION The data found in this study is consistent with the findings of the current literature and underscores the need for using devices capable of capturing the two gases (exhaled H 2 and CH 4 ) to improve the sensitivity and hence the accuracy of small intestine bacterial overgrowth diagnosis in daily medical practice.

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Treatment of Small Intestine Bacterial Overgrowth with Rifaximin, a Non-Absorbable Rifamycin

Journal of International Medical Research ◽

10.1177/030006058801600410 ◽

1988 ◽

Vol 16 (4) ◽

pp. 312-316 ◽

Cited By ~ 32

Author(s):

G. R. Corazza ◽

M. Ventrucci ◽

A. Strocchi ◽

M. Sorge ◽

L. Pranzo ◽

...

Keyword(s):

Small Intestine ◽

Side Effects ◽

Small Bowel ◽

Therapeutic Efficacy ◽

Breath Test ◽

Bacterial Overgrowth ◽

Hydrogen Breath Test ◽

Small Bowel Bacterial Overgrowth ◽

Small Intestine Bacterial Overgrowth ◽

Lactulose Hydrogen Breath Test

In twelve patients affected by small bowel bacterial overgrowth, diagnosed by means of the lactulose hydrogen breath test, the therapeutic efficacy of a non-absorbable derivative of rifamycin, rifaximin, was evaluated. This study showed that this drug has a satisfactory therapeutic efficacy in contaminated small bowel syndrome and, at the doses tested, is free of side-effects.

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