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Comparison of lactulose and glucose breath test for diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome.
Digestion 2012; 85(3):243-7D

Abstract

BACKGROUND AND AIMS

Validity of the lactulose breath test (LBT) to diagnose small intestinal bacterial overgrowth (SIBO) has been questioned. Therefore, a study was planned to compare LBT with glucose breath test (GBT) to diagnose SIBO in irritable bowel syndrome (IBS) patients and controls.

METHODS

175 diarrhea-predominant IBS patients and 150 apparently healthy controls were enrolled. IBS was diagnosed according to Rome II criteria. Breath samples were collected every 10 min up to 180 min. Breath H₂ and CH₄ were measured using an SC MicroLyzer. SIBO was positive with a sustained increase in breath H₂ or CH₄ or both ≥10 ppm over a baseline value within <90 min in case of LBT and within <120 min in GBT.

RESULTS

SIBO was positive in 60/175 (34.3%) patients by lactulose and in 11/175 (6.2%) patients by GBT. In controls, LBT was positive for SIBO in 45/150 (30%) patients and in 1/150 (0.66%) patients by GBT. Positive LBT for SIBO was not significantly different in patients and controls; while using GBT, SIBO was significantly higher (p < 0.01) in patients as compared to controls. By using GBT as gold standard for SIBO, sensitivity, specificity, positive predictive value and negative predictive value of LBT in IBS patients was 63.6, 67.7, 11.7 and 96.6% respectively.

CONCLUSION

LBT is not a good test to discriminate SIBO in IBS patients from controls.

Authors+Show Affiliations

Department of Super Specialty of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. svrana25@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22472730

Citation

Rana, S V., et al. "Comparison of Lactulose and Glucose Breath Test for Diagnosis of Small Intestinal Bacterial Overgrowth in Patients With Irritable Bowel Syndrome." Digestion, vol. 85, no. 3, 2012, pp. 243-7.
Rana SV, Sharma S, Kaur J, et al. Comparison of lactulose and glucose breath test for diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Digestion. 2012;85(3):243-7.
Rana, S. V., Sharma, S., Kaur, J., Sinha, S. K., & Singh, K. (2012). Comparison of lactulose and glucose breath test for diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Digestion, 85(3), pp. 243-7. doi:10.1159/000336174.
Rana SV, et al. Comparison of Lactulose and Glucose Breath Test for Diagnosis of Small Intestinal Bacterial Overgrowth in Patients With Irritable Bowel Syndrome. Digestion. 2012;85(3):243-7. PubMed PMID: 22472730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of lactulose and glucose breath test for diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome. AU - Rana,S V, AU - Sharma,S, AU - Kaur,J, AU - Sinha,S K, AU - Singh,K, Y1 - 2012/03/30/ PY - 2011/10/25/received PY - 2012/01/03/accepted PY - 2012/4/5/entrez PY - 2012/4/5/pubmed PY - 2012/9/26/medline SP - 243 EP - 7 JF - Digestion JO - Digestion VL - 85 IS - 3 N2 - BACKGROUND AND AIMS: Validity of the lactulose breath test (LBT) to diagnose small intestinal bacterial overgrowth (SIBO) has been questioned. Therefore, a study was planned to compare LBT with glucose breath test (GBT) to diagnose SIBO in irritable bowel syndrome (IBS) patients and controls. METHODS: 175 diarrhea-predominant IBS patients and 150 apparently healthy controls were enrolled. IBS was diagnosed according to Rome II criteria. Breath samples were collected every 10 min up to 180 min. Breath H₂ and CH₄ were measured using an SC MicroLyzer. SIBO was positive with a sustained increase in breath H₂ or CH₄ or both ≥10 ppm over a baseline value within <90 min in case of LBT and within <120 min in GBT. RESULTS: SIBO was positive in 60/175 (34.3%) patients by lactulose and in 11/175 (6.2%) patients by GBT. In controls, LBT was positive for SIBO in 45/150 (30%) patients and in 1/150 (0.66%) patients by GBT. Positive LBT for SIBO was not significantly different in patients and controls; while using GBT, SIBO was significantly higher (p < 0.01) in patients as compared to controls. By using GBT as gold standard for SIBO, sensitivity, specificity, positive predictive value and negative predictive value of LBT in IBS patients was 63.6, 67.7, 11.7 and 96.6% respectively. CONCLUSION: LBT is not a good test to discriminate SIBO in IBS patients from controls. SN - 1421-9867 UR - https://www.unboundmedicine.com/medline/citation/22472730/Comparison_of_lactulose_and_glucose_breath_test_for_diagnosis_of_small_intestinal_bacterial_overgrowth_in_patients_with_irritable_bowel_syndrome_ L2 - https://www.karger.com?DOI=10.1159/000336174 DB - PRIME DP - Unbound Medicine ER -