Abnormal breath tests to lactose, fructose and sorbitol in irritable bowel syndrome may be explained by small intestinal bacterial overgrowth

Nucera, Gabriella; Gabrielli, Maurizio; Lupascu, A.; Lauritano, Ernesto Cristiano; Santoliquido, Angelo; Cremonini, Filippo; Cammarota, Giovanni; Tondi, Paolo; Pola, Paolo; Gasbarrini, Giovanni; Gasbarrini, Antonio

doi:10.1111/j.1365-2036.2005.02493.x

Cited by 173 publications

(132 citation statements)

References 26 publications

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“…33 Furthermore, antibiotic therapy abolished FM in a high proportion of patients who had presumed SIBO, which was concomitant with reductions in symptoms. 34 Interestingly, 2 of the asymptomatic control individuals showed positive results on the SIBO test. Additional studies using larger numbers of participants are required.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth

Jung

Seo

Cho

et al. 2018

J Neurogastroenterol Motil

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Background/AimsFructose malabsorption (FM) mimics symptoms of irritable bowel syndrome (IBS), and its prevalence has increased. Diagnosing FM in IBS is challenging because of its overlap with small intestinal bacterial overgrowth (SIBO). We assessed the prevalence of FM by comparing patients with IBS with asymptomatic control individuals after excluding SIBO using the glucose hydrogen breath test (HBT). MethodsPatients diagnosed with IBS and asymptomatic control individuals were enrolled prospectively. Dietary habits were assessed with the Food Frequency Questionnaire. After excluding SIBO, participants underwent HBTs with both 15 g and 25 g of fructose. Results Thirty 040). Analysis of the Food FrequencyQuestionnaire responses showed no significant differences between the 2 groups in dietary intake, although patients with IBS showed a significantly higher mean fiber intake than controls (21.24 ± 11.35 g vs 15.87 ± 7.07 g, respectively, P = 0.040). ConclusionsThe 25-g fructose HBT identified FM in a significantly higher percentage of SIBO-negative patients with IBS than in asymptomatic control individuals, suggesting that FM may correlate with IBS. Education regarding dietary control of foods containing fructose may be useful for the management of patients with IBS. (J Neurogastroenterol Motil 2018;24:307-316)

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Section: Discussionmentioning

confidence: 99%

Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth

Jung

Seo

Cho

et al. 2018

J Neurogastroenterol Motil

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“…With this method, it was reported in 2000 that SIBO was present in 78% of IBS, and that IBS symptoms were improved by treatment with antibiotics [6]. However, in subsequent studies, the incidence of SIBO in IBS was reported to be not as high [7]- [13].…”

Section: Introductionmentioning

confidence: 98%

Pilot Study on Gas Patterns of Irritable Bowel Syndrome and Small Intestinal Bacterial Overgrowth Following Ingestion of Lactulose

Uno¹

2015

OJGas

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Background & Aims: Fermentation site and increasing time of symptomatic gas would be different between irritable bowel syndrome (IBS) and small intestine bacterial overgrowth (SIBO). The aim of this study was to determine the time for increase in abdominal gas following ingestion of lactulose and the possibility of differential diagnosis of SIBO and IBS. Methods: A prospective study was conducted on a series of IBS patients (n = 14) who were referred to the Oroku-Hospital (Okinawa, Japan) from June 6, 2014 to December 30, 2014. Imaging was first performed in early morning after fasting. After ingestion of lactulose, 1 -4 plain abdominal radiographs were taken for investigation of increased gas during the indicated timeframe. Regions of interest of the gas areas were highlighted on the images obtained. Gas images were divided into three areas, the stomach, small intestine, and large intestine, and each total area was calculated. Results: At a dose of 10 g lactulose and an observation time of two hours, patients displayed no symptoms, and the gas volume was only slightly increased. However, when the dose of lactulose was increased (13 g/50 kg), and the observation time for the lactulose challenge was extended to 240 -300 minutes, the results clearly demonstrated an increase in the gas produced in IBS patients. Conclusions: An increased dose of lactulose coupled with an extended observation time for the lactulose challenge clearly demonstrated an increase in the gas produced in IBS patients. Alterations in diet rather than antibiotics might reduce IBS symptoms.

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“…More recently, the role of the gut flora in IBS has been taken a stage further with the suggestion that some IBS patients may harbour quantitative changes in the indigenous flora in the small intestine: small intestinal bacterial overgrowth (SIBO) (68)(69)(70)(71)(72). The occurrence of SIBO has been associated with abnormalities in small intestinal motor function (73) and its eradication with symptomatic relief (68,69,72,(74)(75)(76)(77).…”

Section: Qualitative or Quantitative Changes In The Enteric Flora (Mimentioning

confidence: 99%

Irritable bowel syndrome; update on pathophysiology and management

Quigley¹,

Craig²

2012

Turk J Gastroenterol

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The functional gastrointestinal disorders (FGID) are symptom-based disorders that cannot be currently explained by definable structural or biochemical causes (1). These disorders are common: the presence of at least one functional GI disorder was identified in 70% of participants in a large US householder survey (2). An associated co-morbid psychiatric condition such as anxiety, mood or panic disorder is seen in up to 60% of those attending gastroenterology outpatient clinics with a functional compliant (3). Functional GI disorders are associated with significant impairment of quality of

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Abnormal breath tests to lactose, fructose and sorbitol in irritable bowel syndrome may be explained by small intestinal bacterial overgrowth

Cited by 173 publications

References 26 publications

Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth

Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth

Pilot Study on Gas Patterns of Irritable Bowel Syndrome and Small Intestinal Bacterial Overgrowth Following Ingestion of Lactulose

Irritable bowel syndrome; update on pathophysiology and management

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