Abstract SIBO2.docx

1、Abstract SIBO2Abstract SIBO2South Med J.2016 May;109(5):296-9. doi: 10.14423/SMJ.0000000000000454.Does Carbohydrate Challenge Testing Predict Clinical Response in Small Intestinal Bacterial Overgrowth?Long SK1,Di Palma JA1.Author information 1From the Division of Gastroenterology, University of Sout

2、h Alabama College of Medicine, Mobile.AbstractOBJECTIVES:Small intestinal bacterial overgrowth (SIBO) is considered a frequent cause of abdominal symptoms in patients with surgically altered intestinal anatomy or dysmotility conditions and is recognized as a contributing factor in the exacerbation o

3、f irritable bowel syndrome symptoms. Diagnostic testing can be used to detect the condition.METHODS:The study group comprised patients who had breath hydrogen and methane lactulose challenge testing. All of the patients were treated with antibiotic regimens that have shown benefit forSIBO. The lactu

4、lose challenge was administered orally at 15 g. Hydrogen and methane in expired air were measured and hydrogen values were recorded as the hydrogen plus twice the methane result. Breath tests were analyzed for positivity based on single and multiple criteria of fasting baseline elevation, early rise

5、, and second peak hydrogen rise. Global improvement of gastrointestinal symptoms was assessed by telephone contact or record review.RESULTS:One hundred participants (78 women) were included in the analysis. The mean age was 51 years. A total of 15% of participants did not meet any criteria on breath

6、 testing forSIBO; 73% had a fasting baseline elevation 10 ppm; and 19% had an increase of 20 ppm above baseline in the first 20 minutes, 48% had a 20-ppm increase in the first 60 minutes, and 32% had a second increase, reflecting a colon peak. Overall, 74% responded to a course of antibiotics, deter

7、mined by reported improvement in more than half of the symptoms within 3 months. In total, 67% (10/15) of the subjects who tested negative forSIBO, by all criteria, had a favorable response to antibiotics. Among those with positive hydrogen increases, 76.3% with 1 criterion responded, 66.7% with 2 c

8、riteria responded, 84.6% with 3 responded, and 76.9% with 4 responded. After antibiotic treatment, 88.7% (47/53) of those who had diarrhea reported improvement, 63.3% (19/30) with constipation reported improvement, and 74.3% (52/70) with baseline bloating experienced improvement. Sixty-five of the 8

9、2 patients with pain or discomfort reported improvement (79.3%). Of those treated with a rifaximin regimen, 74.2% (49/66) reported a response to treatment. Twenty of 28 (71.4%) treated with amoxicillin/clavulanate experienced a clinical response.CONCLUSIONS:These data suggest that the response to an

10、tibiotic therapy in patients with suspectedSIBOis not predicted by carbohydrateSIBOtesting results and bring into question the value of such testing.J Breath Res.2016 May 10;10(2):026010. doi: 10.1088/1752-7155/10/2/026010.Hydrogen sulphide in exhaled breath: a potential biomarker for small intestin

11、al bacterial overgrowth in IBS.Banik GD1,De A,Som S,Jana S,Daschakraborty SB,Chaudhuri S,Pradhan M.Author information 1Department of Chemical, Biological and Macromolecular Sciences, S N Bose National Centre for Basic Sciences, Salt Lake, JD Block, Sector III, Kolkata 700098, India.AbstractThere is

12、a pressing need to develop a novel early-detection strategy for the precise evolution of small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome (IBS) patients. The current method based on a hydrogen breath test (HBT) for the detection ofSIBOis highly controversial. HBT has many lim

13、itations and drawbacks. It often fails to indentifySIBOwhen IBS individuals have non-hydrogen-producing colonic bacteria. Here, we show that hydrogen sulphide (H2S) in exhaled breath is distinctly altered for diarrhea-predominant IBS individuals with positive and negativeSIBOby the activity of intes

14、tinal sulphate-reducing bacteria. Subsequently, by analyzing the excretion kinetics of breath H2S, we found a missing link between breath H2S andSIBOwhen HBT often fails to diagnoseSIBO. Moreover, breath H2S can track the precise evolution ofSIBO, even after the eradication of bacterial overgrowth.

15、Our findings suggest that the changes in H2S in the bacterial environment may contribute to the pathogenesis ofSIBOand the breath H2S as a potential biomarker for non-invasive, rapid and precise assessment ofSIBOwithout the endoscopy-based microbial culture of jejunal aspirates, and thus may open ne

16、w perspectives into the pathophysiology ofSIBOin IBS subjects.Therap Adv Gastroenterol.2016 May;9(3):265-72. doi: 10.1177/1756283X15621231. Epub 2015 Dec 31.Refining small intestinal bacterial overgrowth diagnosis by means of carbohydrate specificity: a proof-of-concept study.Enko D1,Halwachs-Bauman

17、n G2,Stolba R2,Mangge H3,Kriegshuser G4.Author information 1Institute of Clinical Chemistry and Laboratory Medicine and Department of Gastroenterology, General Hospital Steyr, Sierningerstrae 170, 4400 Steyr, Austria. 2Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr,

18、Steyr, Austria. 3Clinical Institute of Medical and Laboratory Diagnostics, Medical University of Graz, Graz, Austria. 4Institute of Clinical Chemistry and Laboratory Medicine and Department of Gastroenterology, General Hospital Steyr, Steyr, Austria.AbstractBACKGROUND:Diagnosis of small intestinal b

19、acterial overgrowth (SIBO) remains challenging. This study aimed at proving the diagnostic concept of carbohydrate-specific SIBO (cs-SIBO) using glucose, fructose and sorbitol hydrogen (H2)/methane(CH4)breathtesting (HMBT).METHODS:In this study 125 patients referred to our outpatient clinic for SIBO

20、 testing were included. All individuals underwent glucose (50 g), fructose (25 g) and sorbitol (12.5 g) HMBT at 3 consecutive days. Patients with cs-SIBO (i.e. early H2/CH4 peak) were given rifaximin (600 mg/day) in a 10-day treatment. HMBT results were reassessed in a subset of patients 3-6 months

21、after antibiotic therapy. In view of cs-SIBO diagnosis, agreements between HMBT results obtained for different sugars were calculated using Cohens kappa () with 95% confidence intervals (CIs).RESULTS:A total of 59 (47.2%) patients presented an early H2/CH4 peak with one or more sugars. Among these,

22、21 (16.8%), 10 (8.0%) and 7 (5.6%) individuals had a positive HMBT result with either glucose, fructose or sorbitol, respectively. Another 21 (16.8%) patients with a positive glucose HMBT result were also found positive with an early H2/CH4 peak obtained after ingestion of fructose and/or sorbitol.

23、Fair agreement was observed between glucose and fructose ( = 0.26, p = 0.0018) and between glucose and sorbitol ( = 0.18, p = 0.0178) HMBT results. Slight agreement was observed between fructose and sorbitol ( = 0.03, p = 0.6955) HMBT results only. Successful antibiotic therapy with rifaximin could

24、be demonstrated in 26/30 (86.7%) of patients as indicated by normal HMBT results and symptom remission.CONCLUSIONS:Combined glucose, fructose and sorbitol HMBT has the potential to optimize cs-SIBO diagnosis. Furthermore, the majority of patients with cs-SIBO seem to benefit from rifaximin therapy r

25、egardless of its carbohydrate specificity.Mol Clin Oncol.2016 May;4(5):883-887. Epub 2016 Mar 7.Prevalence and treatment of small intestinal bacterial overgrowth in postoperative patients with colorectal cancer.Deng L1,Liu Y1,Zhang D2,Li Y1,Xu L1.Author information 1Department of Gastroenterology, Q

26、ingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong 266071, P.R. China. 2Department of Hepatobiliary Surgery, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong 266071, P.R. China.AbstractTo investigate the prevalence of small intestinal bacteria

27、l overgrowth (SIBO) in patients with colorectal cancer (CRC) after surgical treatment and observe whether gastrointestinal symptoms may improve with rifaximin, 43 postoperative CRC patients (CRC group) and 30 healthy individuals (normal group) were subjected to the glucose hydrogenbreathtest (GHBT).

28、 All the patients were asked to evaluate the gastrointestinal symptoms using the visual analogue scale (VAS). SIBO-positive patients were administered rifaximin for 10 days on the basis of the original treatment. After the treatment, the patients were asked to undergo GHBT and re-evaluate the gastro

29、intestinal symptoms score (GISS). The results demonstrated that 18 of the 43 postoperative patients with CRC were SIBO-positive (41.86%), which was significantly higher compared with the incidence in normal controls (6.67%) (P0.05). GISS was higher in SIBO-positive patients (P0.05). Following rifaxi

30、min treatment, 6 of the 18 (33.33%) SIBO-positive patients had improved, as evaluated by GHBT and VAS. Additionally, the GISS in the SIBO-turned-negative group had improved significantly compared with that in the non-turned-negative group (P0.05). The symptoms of all 18 SIBO-positive patients follow

31、ing rifaximin treatment improved notably, particularly diarrhea (P0.05). In conclusion, postoperative CRC patients are more likely to develop SIBO compared with healthy individuals, and SIBO may aggravate digestive symptoms. The administration of rifaximin improved the overall gastrointestinal sympt

32、oms, particularly diarrhea, in SIBO-positive patients.Biomed Res Int.2016;2016:1064029. doi: 10.1155/2016/1064029. Epub 2016 Mar 17.Lactulose HydrogenBreathTest Result Is Associated with Age and Gender.Newberry C1,Tierney A2,Pickett-Blakely O1.Author information 1University of Pennsylvania Perelman School of Medicine, Division of Gastroenterology, Philadelphia, PA 19104, USA. 2University of Pennsylvania Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA 19104, USA.AbstractSmall intestinal bac