Tu1738 Glucose Breath Test in Patients With Overlapping FD and IBS. Is There Any Difference Compared to Patients With Only FD or Only IBS?

Sosa, Olivia Rascon; Amieva-Balmori, Mercedes; Galvez-Rios, Shareni; Gutierrez, Xaira J. Rivera; Contreras, Ana; Sanchez-Maza, Yolopsi de Jesús; Dietlen, Federico B. Roesch; Troche, José M. Remes

doi:10.1016/s0016-5085(16)33149-3

Cited by 2 publications

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“…Discussion: Although a strong difference in the prevalence of SIBO was found between patients with IBS and healthy controls, clinicians do not require a test to differentiate between those with IBS and those who are asymptomatic. Studies have rarely evaluated other control groups, but those that did found that SIBO was either just as or more prevalent in those with functional diarrhea (63) and functional dyspepsia (64), with the latter finding not explained by proton pump inhibitor use.…”

Section: Recommendationsmentioning

confidence: 99%

Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)

Martin

Andrews

MacQueen

et al. 2019

Journal of the Canadian Association of Gastroenterology

124

156

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Background & aims Irritable bowel syndrome (IBS) is one of the most common gastrointestinal (GI) disorders, affecting about 10% of the general population globally. The aim of this consensus was to develop guidelines for the management of IBS. Methods A systematic literature search identified studies on the management of IBS. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Statements were developed through an iterative online platform and then finalized and voted on by a multidisciplinary group of clinicians and a patient. Results Consensus was reached on 28 of 31 statements. Irritable bowel syndrome is diagnosed based on symptoms; serological testing is suggested to exclude celiac disease, but routine testing for C-reactive protein (CRP), fecal calprotectin or food allergies is not recommended. A trial of a low fermentable oligosaccharides, disaccharides, monosaccharides, polyols (FODMAP) diet is suggested, while a gluten-free diet is not. Psyllium, but not wheat bran, supplementation may help reduce symptoms. Alternative therapies such as peppermint oil and probiotics are suggested, while herbal therapies and acupuncture are not. Cognitive behavioural therapy and hypnotherapy are suggested psychological therapies. Among the suggested or recommended pharmacological therapies are antispasmodics, certain antidepressants, eluxadoline, lubiprostone, and linaclotide. Loperamide, cholestyramine and osmotic laxatives are not recommended for overall IBS symptoms. The nature of the IBS symptoms (diarrhea-predominant or constipation-predominant) should be considered in the choice of pharmacological treatments. Conclusions Patients with IBS may benefit from a multipronged, individualized approach to treatment, including dietary modifications, psychological and pharmacological therapies.

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Section: Recommendationsmentioning

confidence: 99%

Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)

Martin

Andrews

MacQueen

et al. 2019

Journal of the Canadian Association of Gastroenterology

124

156

View full text Add to dashboard Cite

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“…As stated above, rifaximin is only modestly effective even in breath test positive patients and is no more effective than other alternatives. Furthermore, there are many GI diseases associated with a positive breath test where there is no recommendation to conduct breath testing, such as dyspepsia, 42,[44][45][46][47] gastroesophageal reflux disease (GERD), 48 celiac disease 49 and ulcerative colitis. 50 Overall, there was no association between a positive breath test and IBS when disease controls were used rather than healthy controls (Figure 5), except in the case of GERD, where all GERD patients were on a PPI.…”

Section: Meta-analyses Show a Higher Proportion Of Ibs Patients Have ...mentioning

confidence: 99%

Critical appraisal of the SIBO hypothesis and breath testing: A clinical practice update endorsed by the European society of neurogastroenterology and motility (ESNM) and the American neurogastroenterology and motility society (ANMS)

Kashyap,

Moayyedi,

Quigley

et al. 2024

Neurogastroenterology Motil

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BackgroundThere is compelling evidence that microbe‐host interactions in the intestinal tract underlie many human disorders, including disorders of gut‐brain interactions (previously termed functional bowel disorders), such as irritable bowel syndrome (IBS). Small intestinal bacterial overgrowth (SIBO) has been recognized for over a century in patients with predisposing conditions causing intestinal stasis, such as surgical alteration of the small bowel or chronic diseases, including scleroderma and is associated with diarrhea and signs of malabsorption. Over 20 years ago, it was hypothesized that increased numbers of small intestine bacteria might also account for symptoms in the absence of malabsorption in IBS and related disorders. This SIBO‐IBS hypothesis stimulated significant research and helped focus the profession's attention on the importance of microbe‐host interactions as a potential pathophysiological mechanism in IBS.PurposeHowever, after two decades, this hypothesis remains unproven. Moreover, it has led to serious unintended consequences, namely the widespread use of unreliable and unvalidated breath tests as a diagnostic test for SIBO and a resultant injudicious use of antibiotics. In this review, we examine why the SIBO hypothesis remains unproven and, given the unintended consequences, discuss why it is time to reject this hypothesis and its reliance on breath testing. We also examine recent IBS studies of bacterial communities in the GI tract, their composition and functions, and their interactions with the host. While these studies provide important insights to guide future research, they highlight the need for further mechanistic studies of microbe‐host interactions in IBS patients before we can understand their possible role in diagnosis and treatment of patient with IBS and related disorders.

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Tu1738 Glucose Breath Test in Patients With Overlapping FD and IBS. Is There Any Difference Compared to Patients With Only FD or Only IBS?

Cited by 2 publications

References 0 publications

Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)

Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)

Critical appraisal of the SIBO hypothesis and breath testing: A clinical practice update endorsed by the European society of neurogastroenterology and motility (ESNM) and the American neurogastroenterology and motility society (ANMS)

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