Costa Michelle Bafutto Gomes, Azeredo Itaciron Luz, Marciano Ricardo Duarte, Caldeira Luciana Morelli, Bafutto Mauro
Departamento de Medicina, Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brazil.
Arq Gastroenterol. 2012 Dec;49(4):279-83. doi: 10.1590/s0004-28032012000400009.
Functional dyspepsia is a condition in which symptoms are not related to organic underlying disease; its pathogenesis is not well known. The small intestinal bacterial overgrowth (SIBO) is characterized by the increase in the number and/or type of colonic bacteria in the upper gastrointestinal tract. The hypothesis of SIBO being associated to functional dyspepsia must be considered, since the impaired motility of the gastrointestinal tract is one of the main etiologic factors involved on both pathologies.
To determine if there is SIBO in patients with functional dyspepsia.
Case-control study, evaluating 34 patients: 23 functional dyspeptic and 11 non-dyspeptic (control group). Questionnaire applied based on Rome III criteria. The patients underwent H2-lactulose breath test, considered positive when: H2 peak exceeding 20 ppm, in relation to fasting, or two peaks exceeding 10 ppm sustained until 60 minutes.
Of the 23 dyspeptic patients, 13 (56.5%) obtained positive results for SIBO trough the H2-lactulose breath test. On control group, SIBO was not observed. The association between the dyspeptic group and the control group regarding SIBO was statistically significant, with P = 0.0052. In the group of dyspeptic patients, 12 (52.2%) were using proton pump inhibitor; of these 9 (75%) were positive for SIBO. In the control group, none of the 11 patients used proton pump inhibitors and SIBO was not observed. The association of the dyspeptic group using proton pump inhibitor that were positive for SIBO and the control group was statistically significant, with P = 0.0011.
It was found that, patients with functional dyspepsia presented SIBO, when they underwent to H2-lactulose breath test, compared to the non-dyspeptic. In addition, it was observed a higher prevalence of SIBO in dyspeptic patients that were using proton pump inhibitors, compared to control group.
功能性消化不良是一种症状与潜在器质性疾病无关的病症；其发病机制尚不清楚。小肠细菌过度生长（SIBO）的特征是上消化道中结肠细菌的数量和/或种类增加。由于胃肠道动力障碍是这两种病症的主要病因之一，因此必须考虑SIBO与功能性消化不良相关的假说。
确定功能性消化不良患者是否存在SIBO。
病例对照研究，评估34例患者：23例功能性消化不良患者和11例无消化不良患者（对照组）。根据罗马III标准应用问卷。患者接受H2-乳果糖呼气试验，当符合以下情况时判定为阳性：相对于空腹，H2峰值超过20 ppm，或两个峰值超过10 ppm并持续至60分钟。
在23例消化不良患者中，13例（56.5%）通过H2-乳果糖呼气试验获得SIBO阳性结果。在对照组中，未观察到SIBO。消化不良组和对照组在SIBO方面的关联具有统计学意义，P = 0.0052。在消化不良患者组中，12例（52.2%）正在使用质子泵抑制剂；其中9例（75%）SIBO呈阳性。在对照组中，11例患者均未使用质子泵抑制剂，也未观察到SIBO。使用质子泵抑制剂且SIBO呈阳性的消化不良组与对照组之间的关联具有统计学意义，P = 0.0011。
发现与无消化不良患者相比，功能性消化不良患者在接受H2-乳果糖呼气试验时存在SIBO。此外，与对照组相比，正在使用质子泵抑制剂的消化不良患者中SIBO的患病率更高。
