The prevalence of small intestine bacterial overgrowth in irritable bowel syndrome is much higher with lactulose than glucose breath test: Results of a retrospective monocentric study - 20/10/24
, Fabien Subtil b, Christelle Machon c, Sabine Roman a, Anne Mialon cHighlights |
• | Small intestinal bacterial overgrowth (SIBO) may be associated with irritable bowel syndrome (IBS), but its occurrence is rare in the absence of known factors responsible for SIBO. |
• | Lactulose and glucose breath tests are indirect tests recommended for the diagnosis of SIBO. |
• | However, both tests may not be equivalent for this diagnosis. |
• | This retrospective study confirmed that the positivity of lactulose breath test is 10 times higher than glucose breath test in IBS patients. |
• | Lactulose breath test should not be used anymore for the diagnosis of SIBO. |
Abstract |
Background |
Glucose (GBT) and lactulose (LBT) breath tests have been recommended for the diagnosis of small intestinal bacterial overgrowth (SIBO). LBT may yield a higher prevalence of SIBO diagnosis, because of its limited small bowel absorption, and therefore colonic fermentation. The aim of this retrospective study was to confirm this hypothesis, in irritable bowel syndrome patients (IBS).
Methods |
Among a cohort of 995 patients who underwent GBT or LBT, 287 with typical IBS according to Rome IV criteria, without past digestive surgery or significant medical comorbidities, were included.
Results |
155 IBS patients underwent GBT, and 132 LBT (71% women, mean age 45±15, mean BMI: 22.6±4.3 kg/m2). There were no difference between both groups in terms of demographics, IBS type and severity of symptoms. The prevalence of SIBO according to LBT was 47%, versus 4.5% only with GBT (p<0.001). The prevalence of methane values ≥ 10 ppm were similar in both groups (34%).
Conclusion |
LBT is very frequently positive in IBS patients, as compared to GBT. The 2 tests are thus not interchangeable for the diagnosis of SIBO. Furthermore, the positivity of both tests was not correlated with symptoms, which may indicate a poor clinical interest of these tests in IBS.
Il testo completo di questo articolo è disponibile in PDF.Key words : Carbohydrate breath tests, Hydrogen, Methane, Small intestine bacterial overgrowth, Irritable bowel syndrome
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Vol 48 - N° 9
Articolo 102482- Novembre 2024 Ritorno al numero
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