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Small intestinal bacterial overgrowth as an uncommon cause of false positive lactose hydrogen breath test among patients with diarrhea‐predominant irritable bowel syndrome in A sia
Author(s) -
Wang Yilin,
Xiong Lishou,
Gong Xiaorong,
Li Weimin,
Zhang Xiangsong,
Chen Minhu
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12862
Subject(s) - hydrogen breath test , irritable bowel syndrome , small intestinal bacterial overgrowth , medicine , gastroenterology , lactose , malabsorption , breath test , lactulose , diarrhea , lactose intolerance , food science , helicobacter pylori , biology
Background and Aim It has been reported that small intestinal bacterial overgrowth ( SIBO ) may lead to false positive diagnoses of lactose malabsorption ( LM ) in irritable bowel syndrome patients. The aim of this study was to determine the influence of SIBO on lactose hydrogen breath test ( HBT ) results in these patients. Methods Diarrhea‐predominant irritable bowel syndrome patients with abnormal lactose HBT s ingested a test meal containing 99m T c and lactose. The location of the test meal and the breath levels of hydrogen were recorded simultaneously by scintigraphic scanning and lactose HBT , respectively. The increase in hydrogen concentration was not considered to be caused by SIBO if ≥ 10% of 99m T c accumulated in the cecal region at the time or before of abnormal lactose HBT . Results LM was present in 84% (31/37) of irritable bowel syndrome patients. Twenty of these patients agreed to measurement of oro‐cecal transit time. Only three patients (15%) with abnormal lactose HBT might have had SIBO . The median oro‐cecal transit time between LM and lactose intolerance patients were 75 min and 45 min, respectively (Z = 2.545, P = 0.011). Conclusions Most of irritable bowel syndrome patients with an abnormal lactose HBT had LM . SIBO had little impact on the interpretation of lactose HBT s. The patients with lactose intolerance had faster small intestinal transit than LM patients.