Department of Gastroenterology, GB Pant Hospital, New Delhi, India.
J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:135-8. doi: 10.1111/j.1440-1746.2011.06654.x.
Small intestinal bacterial overgrowth (SIBO) has been implicated in pathogenesis of IBS. We aimed to study frequency and predictors of SIBO in patients with IBS.
We included 59 consecutive patients of IBS & 37 healthy controls (HC). Evaluation for SIBO was done by glucose breath test (GBT) using 100 gm of glucose after an overnight fast. Breath hydrogen & methane concentration were noted at baseline & every 15 min after administration of glucose for a total of 3 h. Persistent rise in breath hydrogen or methane > 12 ppm above basal was considered diagnostic of SIBO.
Of 59 patients, 27 were diarrhoea predominant (D-IBS), 11 were constipation predominant (C-IBS) and 21 were mixed type (M-IBS). Median age of patients (34 [18-47] years) were comparable to controls (35 [20-48] years) (P = 0.21). Patient group was similar to HC in gender distribution (male 41/59 [69.5%]vs 25/37 [67.6%], P = 0.36). SIBO was more frequent in patients with IBS than HC (14/59 [23.7%]vs 1/37 [2.7%], P = 0.008). Patients with D-IBS more often had SIBO as compared to non-D-IBS (10/27 [37%]vs 4/32 [12.5%], P = 0.02). C-IBS had lowest frequency of SIBO (1/11 [9%]) among all IBS subgroups. Patients with history of bloating more often had SIBO as compared to those without this symptom (11/23 [47.8%]vs 3/36 [8.3%], P = 0.002). Among IBS patients, females more often had SIBO as compared to males (8/18 [44.4%]vs 6/41 [14.6%], P = 0.01).
SIBO was more frequent in patients with IBS as compared to healthy controls. D-IBS subtype, female gender & bloating were predictors of SIBO in patients with IBS.
小肠细菌过度生长(SIBO)与 IBS 的发病机制有关。我们旨在研究 IBS 患者 SIBO 的频率和预测因素。
我们纳入了 59 例连续的 IBS 患者和 37 例健康对照者(HC)。SIBO 的评估通过葡萄糖呼气试验(GBT)进行,在禁食过夜后给予 100 克葡萄糖。在给予葡萄糖后,每 15 分钟记录一次氢和甲烷的呼气浓度,共 3 小时。呼气氢或甲烷持续升高,比基础值升高 12 ppm 以上被认为是 SIBO 的诊断标准。
59 例患者中,27 例为腹泻型 IBS(D-IBS),11 例为便秘型 IBS(C-IBS),21 例为混合型(M-IBS)。患者的中位年龄(34[18-47]岁)与对照组(35[20-48]岁)相当(P=0.21)。患者组在性别分布上与 HC 相似(男性 41/59[69.5%] vs 25/37[67.6%],P=0.36)。与 HC 相比,IBS 患者中 SIBO 的发生率更高(14/59[23.7%] vs 1/37[2.7%],P=0.008)。与非 D-IBS 相比,D-IBS 患者更常发生 SIBO(10/27[37%] vs 4/32[12.5%],P=0.02)。所有 IBS 亚组中,C-IBS 的 SIBO 发生率最低(1/11[9%])。与无腹胀症状的患者相比,有腹胀症状的患者更常发生 SIBO(11/23[47.8%] vs 3/36[8.3%],P=0.002)。在 IBS 患者中,女性比男性更常发生 SIBO(8/18[44.4%] vs 6/41[14.6%],P=0.01)。
与健康对照组相比,IBS 患者 SIBO 的发生率更高。D-IBS 亚型、女性和腹胀是 IBS 患者 SIBO 的预测因素。