Pimentel M, Wallace D, Hallegua D, Chow E, Kong Y, Park S, Lin H C
GI Motility Program, Divisions of Gastroenterology and Rheumatology, Department of Medicine, Cedars-Sinai Medical Center, CSMC Burns & Allen Research Institute, Los Angeles, California 90048, USA.
Ann Rheum Dis. 2004 Apr;63(4):450-2. doi: 10.1136/ard.2003.011502.
An association between irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) has been found.
To compare the prevalence and test results for bacterial overgrowth between IBS and fibromyalgia.
Subjects with independent fibromyalgia and IBS were compared with controls in a double blind study. Participants completed a questionnaire, and a lactulose hydrogen breath test was used to determine the presence of SIBO. The prevalence of an abnormal breath test was compared between study participants. Hydrogen production on the breath test was compared between subjects with IBS and fibromyalgia. The somatic pain visual analogue score of subjects with fibromyalgia was compared with their degree of hydrogen production.
3/15 (20%) controls had an abnormal breath test compared with 93/111 (84%) subjects with IBS (p<0.01) and 42/42 (100%) with fibromyalgia (p<0.0001 v controls, p<0.05 v IBS). Subjects with fibromyalgia had higher hydrogen profiles (p<0.01), peak hydrogen (p<0.0001), and area under the curve (p<0.01) than subjects with IBS. This was not dependent on the higher prevalence of an abnormal breath test. The degree of somatic pain in fibromyalgia correlated significantly with the hydrogen level seen on the breath test (r = 0.42, p<0.01).
An abnormal lactulose breath test is more common in fibromyalgia than IBS. In contrast with IBS, the degree of abnormality on breath test is greater in subjects with fibromyalgia and correlates with somatic pain.
已发现肠易激综合征（IBS）与小肠细菌过度生长（SIBO）之间存在关联。
比较IBS和纤维肌痛患者中细菌过度生长的患病率及检测结果。
在一项双盲研究中，将独立诊断为纤维肌痛和IBS的受试者与对照组进行比较。参与者完成一份问卷，并采用乳果糖氢呼气试验来确定是否存在SIBO。比较研究参与者中呼气试验异常的患病率。比较IBS和纤维肌痛患者呼气试验中的产氢量。比较纤维肌痛患者的躯体疼痛视觉模拟评分与其产氢程度。
15名对照组中有3名（20%）呼气试验异常，相比之下，111名IBS患者中有93名（84%）（p<0.01），42名纤维肌痛患者中有42名（100%）（与对照组相比p<0.0001，与IBS相比p<0.05）。纤维肌痛患者的氢曲线（p<0.01）、氢峰值（p<0.0001）和曲线下面积（p<0.01）均高于IBS患者。这并不取决于呼气试验异常的较高患病率。纤维肌痛患者的躯体疼痛程度与呼气试验中观察到的氢水平显著相关（r = 0.42，p<0.01）。
乳果糖呼气试验异常在纤维肌痛患者中比在IBS患者中更常见。与IBS不同，纤维肌痛患者呼气试验的异常程度更大，且与躯体疼痛相关。
