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Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-D-xylose and healthy controls.
Am J Gastroenterol. 2005 Jul; 100(7):1566-70.AJ

Abstract

OBJECTIVES Recent reports suggest bacterial overgrowth is commonly associated with irritable bowel syndrome (IBS) when diagnosed using the lactulose hydrogen breath test (LHBT). We employed this test to examine whether similar findings exist in a geographically distinct population of Rome II positive IBS patients and compared it to the 14C-D-xylose breath test, a test with acknowledged greater specificity for bacterial overgrowth.

METHODS

In the first series, Rome II IBS patients underwent a 10 g lactulose breath test and a standardized 1 g 14C-D-xylose breath test and answered IBS symptom questionnaires. A positive test required an elevated breath hydrogen concentration within 90 min, two distinct peaks, and an increase >20 ppm. In a second series, control patients lacking gastrointestinal symptoms underwent a lactulose breath test. A positive test required an elevation of breath hydrogen >20 ppm within 90 or 180 min. These criteria were also applied to lactulose breath tests from IBS cases in series one.

RESULTS

The IBS patients were predominantly female (64%) and most reported severe symptoms (80%). The majority had diarrhea predominant symptoms (63%) and only 3% were constipation predominant. In the first series, only 10% of patients had a positive lactulose breath test and 13% had a positive 14C-D-xylose test. In the second series, the number of abnormal LHBTs was much higher but no differences were found between IBS patients and controls.

CONCLUSION

The lactulose breath test did not reliably detect a common association between bacterial overgrowth and IBS in our patient population.

Authors+Show Affiliations

Gastrointestinal Diseases Research Unit, Queen's University, Kingston, Ontario, Canada.No affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

15984983

Citation

Walters, B, and S J. Vanner. "Detection of Bacterial Overgrowth in IBS Using the Lactulose H2 Breath Test: Comparison With 14C-D-xylose and Healthy Controls." The American Journal of Gastroenterology, vol. 100, no. 7, 2005, pp. 1566-70.
Walters B, Vanner SJ. Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-D-xylose and healthy controls. Am J Gastroenterol. 2005;100(7):1566-70.
Walters, B., & Vanner, S. J. (2005). Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-D-xylose and healthy controls. The American Journal of Gastroenterology, 100(7), 1566-70.
Walters B, Vanner SJ. Detection of Bacterial Overgrowth in IBS Using the Lactulose H2 Breath Test: Comparison With 14C-D-xylose and Healthy Controls. Am J Gastroenterol. 2005;100(7):1566-70. PubMed PMID: 15984983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-D-xylose and healthy controls. AU - Walters,B, AU - Vanner,S J, PY - 2005/6/30/pubmed PY - 2005/9/1/medline PY - 2005/6/30/entrez SP - 1566 EP - 70 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 100 IS - 7 N2 - UNLABELLED: OBJECTIVES Recent reports suggest bacterial overgrowth is commonly associated with irritable bowel syndrome (IBS) when diagnosed using the lactulose hydrogen breath test (LHBT). We employed this test to examine whether similar findings exist in a geographically distinct population of Rome II positive IBS patients and compared it to the 14C-D-xylose breath test, a test with acknowledged greater specificity for bacterial overgrowth. METHODS: In the first series, Rome II IBS patients underwent a 10 g lactulose breath test and a standardized 1 g 14C-D-xylose breath test and answered IBS symptom questionnaires. A positive test required an elevated breath hydrogen concentration within 90 min, two distinct peaks, and an increase >20 ppm. In a second series, control patients lacking gastrointestinal symptoms underwent a lactulose breath test. A positive test required an elevation of breath hydrogen >20 ppm within 90 or 180 min. These criteria were also applied to lactulose breath tests from IBS cases in series one. RESULTS: The IBS patients were predominantly female (64%) and most reported severe symptoms (80%). The majority had diarrhea predominant symptoms (63%) and only 3% were constipation predominant. In the first series, only 10% of patients had a positive lactulose breath test and 13% had a positive 14C-D-xylose test. In the second series, the number of abnormal LHBTs was much higher but no differences were found between IBS patients and controls. CONCLUSION: The lactulose breath test did not reliably detect a common association between bacterial overgrowth and IBS in our patient population. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15984983/Detection_of_bacterial_overgrowth_in_IBS_using_the_lactulose_H2_breath_test:_comparison_with_14C_D_xylose_and_healthy_controls_ L2 - http://Insights.ovid.com/pubmed?pmid=15984983 DB - PRIME DP - Unbound Medicine ER -