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Arq Gastroenterol. 2017 Apr-Jun;54(2):91-95. doi: 10.1590/S0004-2803.201700000-06. Epub 2017 Feb 23.

PREVALENCE OF SMALL INTESTINE BACTERIAL OVERGROWTH IN PATIENTS WITH GASTROINTESTINAL SYMPTOMS.

Author information

1
Programa de Graduação, Faculdade de Ciências Médicas de Minas Gerais, MG, Brazil.
2
Clínica CEMAD, Belo Horizonte, MG, Brazil.
3
Programa de Pós-Graduação, Faculdade de Ciências Médicas de Minas Gerais, e da Faculdade de Medicina da Universidade Federal de Minas Gerais, MG, Brazil.

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.

PMID:
28273273
DOI:
10.1590/S0004-2803.201700000-06
[Indexed for MEDLINE]
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