Abstract SIBO2.docx

Abstract SIBO2.docx

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AbstractSIBO2

AbstractSIBO2

SouthMedJ. 2016May;109（5）:

296-9.doi:

10.14423/SMJ.0000000000000454.

DoesCarbohydrateChallengeTestingPredictClinicalResponseinSmallIntestinalBacterialOvergrowth?

LongSK1, DiPalmaJA1.

Authorinformation

∙1FromtheDivisionofGastroenterology,UniversityofSouthAlabamaCollegeofMedicine,Mobile.

Abstract

OBJECTIVES:

Smallintestinalbacterialovergrowth（SIBO）isconsideredafrequentcauseofabdominalsymptomsinpatientswithsurgicallyalteredintestinalanatomyordysmotilityconditionsandisrecognizedasacontributingfactorintheexacerbationofirritablebowelsyndromesymptoms.Diagnostictestingcanbeusedtodetectthecondition.

METHODS:

Thestudygroupcomprisedpatientswhohadbreathhydrogenandmethanelactulosechallengetesting.Allofthepatientsweretreatedwithantibioticregimensthathaveshownbenefitfor SIBO.Thelactulosechallengewasadministeredorallyat15g.Hydrogenandmethaneinexpiredairweremeasuredandhydrogenvalueswererecordedasthehydrogenplustwicethemethaneresult.Breathtestswereanalyzedforpositivitybasedonsingleandmultiplecriteriaoffastingbaselineelevation,earlyrise,andsecondpeakhydrogenrise.Globalimprovementofgastrointestinalsymptomswasassessedbytelephonecontactorrecordreview.

RESULTS:

Onehundredparticipants（78women）wereincludedintheanalysis.Themeanagewas51years.Atotalof15%ofparticipantsdidnotmeetanycriteriaonbreathtestingfor SIBO;73%hadafastingbaselineelevation>10ppm;and19%hadanincreaseof>20ppmabovebaselineinthefirst20minutes,48%hada20-ppmincreaseinthefirst60minutes,and32%hadasecondincrease,reflectingacolonpeak.Overall,74%respondedtoacourseofantibiotics,determinedbyreportedimprovementinmorethanhalfofthesymptomswithin3months.Intotal,67%（10/15）ofthesubjectswhotestednegativefor SIBO,byallcriteria,hadafavorableresponsetoantibiotics.Amongthosewithpositivehydrogenincreases,76.3%with1criterionresponded,66.7%with2criteriaresponded,84.6%with3responded,and76.9%with4responded.Afterantibiotictreatment,88.7%（47/53）ofthosewhohaddiarrheareportedimprovement,63.3%（19/30）withconstipationreportedimprovement,and74.3%（52/70）withbaselinebloatingexperiencedimprovement.Sixty-fiveofthe82patientswithpainordiscomfortreportedimprovement（79.3%）.Ofthosetreatedwitharifaximinregimen,74.2%（49/66）reportedaresponsetotreatment.Twentyof28（71.4%）treatedwithamoxicillin/clavulanateexperiencedaclinicalresponse.

CONCLUSIONS:

Thesedatasuggestthattheresponsetoantibiotictherapyinpatientswithsuspected SIBO isnotpredictedbycarbohydrateSIBO testingresultsandbringintoquestionthevalueofsuchtesting.

JBreathRes. 2016May10;10

（2）:

026010.doi:

10.1088/1752-7155/10/2/026010.

Hydrogensulphideinexhaledbreath:

apotentialbiomarkerforsmallintestinalbacterialovergrowthinIBS.

BanikGD1, DeA, SomS, JanaS, DaschakrabortySB, ChaudhuriS, PradhanM.

Authorinformation

∙1DepartmentofChemical,BiologicalandMacromolecularSciences,SNBoseNationalCentreforBasicSciences,SaltLake,JDBlock,SectorIII,Kolkata700098,India.

Abstract

Thereisapressingneedtodevelopanovelearly-detectionstrategyforthepreciseevolutionofsmallintestinalbacterialovergrowth（SIBO）inirritablebowelsyndrome（IBS）patients.Thecurrentmethodbasedonahydrogenbreathtest（HBT）forthedetectionof SIBO ishighlycontroversial.HBThasmanylimitationsanddrawbacks.Itoftenfailstoindentify SIBO whenIBSindividualshave'non-hydrogen-producing'colonicbacteria.Here,weshowthathydrogensulphide（H2S）inexhaledbreathisdistinctlyalteredfordiarrhea-predominantIBSindividualswithpositiveandnegative SIBO bytheactivityofintestinalsulphate-reducingbacteria.Subsequently,byanalyzingtheexcretionkineticsofbreathH2S,wefoundamissinglinkbetweenbreathH2Sand SIBO whenHBToftenfailstodiagnose SIBO.Moreover,breathH2Scantrackthepreciseevolutionof SIBO,evenaftertheeradicationofbacterialovergrowth.OurfindingssuggestthatthechangesinH2Sinthebacterialenvironmentmaycontributetothepathogenesisof SIBO andthebreathH2Sasapotentialbiomarkerfornon-invasive,rapidandpreciseassessmentof SIBOwithouttheendoscopy-basedmicrobialcultureofjejunalaspirates,andthusmayopennewperspectivesintothepathophysiologyof SIBO inIBSsubjects.

TherapAdvGastroenterol. 2016May;9（3）:

265-72.doi:

10.1177/1756283X15621231.Epub2015Dec31.

Refiningsmallintestinalbacterialovergrowthdiagnosisbymeansofcarbohydratespecificity:

aproof-of-conceptstudy.

EnkoD1, Halwachs-BaumannG2, StolbaR2, ManggeH3, KriegshäuserG4.

Authorinformation

∙1InstituteofClinicalChemistryandLaboratoryMedicineandDepartmentofGastroenterology,GeneralHospitalSteyr,Sierningerstraße170,4400Steyr,Austria.

∙2InstituteofClinicalChemistryandLaboratoryMedicine,GeneralHospitalSteyr,Steyr,Austria.

∙3ClinicalInstituteofMedicalandLaboratoryDiagnostics,MedicalUniversityofGraz,Graz,Austria.

∙4InstituteofClinicalChemistryandLaboratoryMedicineandDepartmentofGastroenterology,GeneralHospitalSteyr,Steyr,Austria.

Abstract

BACKGROUND:

Diagnosisofsmallintestinalbacterialovergrowth（SIBO）remainschallenging.Thisstudyaimedatprovingthediagnosticconceptofcarbohydrate-specificSIBO（cs-SIBO）usingglucose,fructoseandsorbitolhydrogen（H2）/methane （CH4） breath testing（HMBT）.

METHODS:

Inthisstudy125patientsreferredtoouroutpatientclinicforSIBOtestingwereincluded.Allindividualsunderwentglucose（50g）,fructose（25g）andsorbitol（12.5g）HMBTat3consecutivedays.Patientswithcs-SIBO（i.e.earlyH2/CH4peak）weregivenrifaximin（600mg/day）ina10-daytreatment.HMBTresultswerereassessedinasubsetofpatients3-6monthsafterantibiotictherapy.Inviewofcs-SIBOdiagnosis,agreementsbetweenHMBTresultsobtainedfordifferentsugarswerecalculatedusingCohen'skappa（κ）with95%confidenceintervals（CIs）.

RESULTS:

Atotalof59（47.2%）patientspresentedanearlyH2/CH4peakwithoneormoresugars.Amongthese,21（16.8%）,10（8.0%）and7（5.6%）individualshadapositiveHMBTresultwitheitherglucose,fructoseorsorbitol,respectively.Another21（16.8%）patientswithapositiveglucoseHMBTresultwerealsofoundpositivewithanearlyH2/CH4peakobtainedafteringestionoffructoseand/orsorbitol.Fairagreementwasobservedbetweenglucoseandfructose（κ=0.26,p=0.0018）andbetweenglucoseandsorbitol（κ=0.18,p=0.0178）HMBTresults.Slightagreementwasobservedbetweenfructoseandsorbitol（κ=0.03,p=0.6955）HMBTresultsonly.Successfulantibiotictherapywithrifaximincouldbedemonstratedin26/30（86.7%）ofpatientsasindicatedbynormalHMBTresultsandsymptomremission.

CONCLUSIONS:

Combinedglucose,fructoseandsorbitolHMBThasthepotentialtooptimizecs-SIBOdiagnosis.Furthermore,themajorityofpatientswithcs-SIBOseemtobenefitfromrifaximintherapyregardlessofitscarbohydratespecificity.

MolClinOncol. 2016May;4（5）:

883-887.Epub2016Mar7.

Prevalenceandtreatmentofsmallintestinalbacterialovergrowthinpostoperativepatientswithcolorectalcancer.

DengL1, LiuY1, ZhangD2, LiY1, XuL1.

Authorinformation

∙1DepartmentofGastroenterology,QingdaoMunicipalHospitalAffiliatedtoQingdaoUniversity,Qingdao,Shandong266071,P.R.China.

∙2DepartmentofHepatobiliarySurgery,QingdaoMunicipalHospitalAffiliatedtoQingdaoUniversity,Qingdao,Shandong266071,P.R.China.

Abstract

Toinvestigatetheprevalenceofsmallintestinalbacterialovergrowth（SIBO）inpatientswithcolorectalcancer（CRC）aftersurgicaltreatmentandobservewhethergastrointestinalsymptomsmayimprovewithrifaximin,43postoperativeCRCpatients（CRCgroup）and30healthyindividuals（normalgroup）weresubjectedtotheglucosehydrogen breath test（GHBT）.Allthepatientswereaskedtoevaluatethegastrointestinalsymptomsusingthevisualanaloguescale（VAS）.SIBO-positivepatientswereadministeredrifaximinfor10daysonthebasisoftheoriginaltreatment.Afterthetreatment,thepatientswereaskedtoundergoGHBTandre-evaluatethegastrointestinalsymptomsscore（GISS）.Theresultsdemonstratedthat18ofthe43postoperativepatientswithCRCwereSIBO-positive（41.86%）,whichwassignificantlyhighercomparedwiththeincidenceinnormalcontrols（6.67%）（P<0.05）.GISSwashigherinSIBO-positivepatients（P<0.05）.Followingrifaximintreatment,6ofthe18（33.33%）SIBO-positivepatientshadimproved,asevaluatedbyGHBTandVAS.Additionally,theGISSintheSIBO-turned-negativegrouphadimprovedsignificantlycomparedwiththatinthenon-turned-negativegroup（P<0.05）.Thesymptomsofall18SIBO-positivepatientsfollowingrifaximintreatmentimprovednotably,particularlydiarrhea（P<0.05）.Inconclusion,postoperativeCRCpatientsaremorelikelytodevelopSIBOcomparedwithhealthyindividuals,andSIBOmayaggravatedigestivesymptoms.Theadministrationofrifaximinimprovedtheoverallgastrointestinalsymptoms,particularlydiarrhea,inSIBO-positivepatients.

BiomedResInt. 2016;2016:

1064029.doi:

10.1155/2016/1064029.Epub2016Mar17.

LactuloseHydrogen Breath TestResultIsAssociatedwithAgeandGender.

NewberryC1, TierneyA2, Pickett-BlakelyO1.

Authorinformation

∙1UniversityofPennsylvaniaPerelmanSchoolofMedicine,DivisionofGastroenterology,Philadelphia,PA19104,USA.

∙2UniversityofPennsylvaniaCenterforClinicalEpidemiologyandBiostatistics,Philadelphia,PA19104,USA.

Abstract

Smallintestinalbac