A study of the methodological and clinical validity of the combined lactulose hydrogen breath test with scintigraphic oro-cecal transit test for diagnosing small intestinal bacterial overgrowth in IBS patients

Neurogastroenterology and Motility

Volumn 26, Issue 6, 2014, Pages 794-802

  Zhao, J ^a,b,c   Zheng, X ^a   Chu, H ^a   Cong, Y ^a   Fried, M ^d,e   Fox, M ^d,e,f   Dai, N ^a  

^a ZHEJIANG UNIVERSITY   (China)

^b Tongde Hospital of Zhejiang Province   (China)

^c HEBEI UNIVERSITY OF ENGINEERING   (China)

^d UNIVERSITY HOSPITAL ZURICH   (Switzerland)

^e UNIVERSITY OF ZURICH   (Switzerland)

^f QUEEN S MEDICAL CENTRE   (United Kingdom)

Author keywords

Antibiotic therapy; Irritable bowel syndrome (IBS); Lactulose hydrogen breath test (LHBT); Rifaximin; Scintigraphic oro cecal transit (SOCT) test; Small intestinal bacterial overgrowth (SIBO)

Indexed keywords

LACTULOSE; PERTECHNETIC ACID TC 99M; RIFAXIMIN; ANTIINFECTIVE AGENT; GASTROINTESTINAL AGENT; RIFAMYCIN;

ADULT; ARTICLE; BACTERIAL OVERGROWTH; CONTROLLED STUDY; DEFECATION; DIAGNOSTIC TEST; DISEASE SEVERITY; FEMALE; GAMMA CAMERA; HUMAN; IRRITABLE COLON; LACTULOSE HYDROGEN BREATH TEST; MAJOR CLINICAL STUDY; MALE; MEASUREMENT; METHODOLOGY; PREVALENCE; PRIORITY JOURNAL; REPRODUCIBILITY; SCINTIGRAPHIC ORO CECAL TRANSIT TEST; SMALL INTESTINE; TREATMENT RESPONSE; VALIDITY; BREATH ANALYSIS; CECUM; DIAGNOSTIC USE; IRRITABLE BOWEL SYNDROME; MICROBIOLOGY; MIDDLE AGED; PILOT STUDY; PROCEDURES; SCINTISCANNING; TREATMENT OUTCOME;

ADULT; ANTI-BACTERIAL AGENTS; BREATH TESTS; CECUM; FEMALE; GASTROINTESTINAL AGENTS; HUMANS; INTESTINE, SMALL; IRRITABLE BOWEL SYNDROME; LACTULOSE; MALE; MIDDLE AGED; PILOT PROJECTS; REPRODUCIBILITY OF RESULTS; RIFAMYCINS; TREATMENT OUTCOME;

EID: 84901400623     PISSN: 13501925     EISSN: 13652982     Source Type: Journal    
DOI: 10.1111/nmo.12331     Document Type: Article

References (40)

1. Simren M, Stotzer PO. Use and abuse of hydrogen breath tests. Gut 2006; 55: 297-303.
2. Cole CR, Ziegler TR. Small bowel bacterial overgrowth: a negative factor in gut adaptation in pediatric SBS. Curr Gastroenterol Rep 2007; 9: 456-62.
3. Vanner S. The small intestinal bacterial overgrowth. Irritable bowel syndrome hypothesis: implications for treatment. Gut 2008; 57: 1315-21.
4. Abu-Shanab A, Quigley EM. Diagnosis of small intestinal bacterial overgrowth: the challenges persist!. Expert Rev Gastroenterol Hepatol 2009; 3: 77-87.
5. Khoshini R, Dai SC, Lezcano S, Pimentel M. A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Dig Dis Sci 2008; 53: 1443-54.
6. Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA 2004; 292: 852-8.
7. Yang J, Deng Y, Chu H, Cong Y, Zhao J, Pohl D, Misselwitz B, Fried M et al. Prevalence and presentation of lactose intolerance and effects on dairy product intake in healthy subjects and patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 2013; 11: 262-8, e1.
8. Zhu Y, Zheng X, Cong Y, Chu H, Fried M, Dai N, Fox M. Bloating and distention in irritable bowel syndrome: the role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency. Am J Gastroenterol 2013; 108: 1516-25.
9. Le Nevé B, Posserud I, Böhn L, Guyonnet D, Rondeau P, Tillisch K, Naliboff B, Mayer EA et al. A combined nutrient and lactulose challenge test allows symptom-based clustering of patients with irritable bowel syndrome. Am J Gastroenterol 2013; 108: 786-95.
10. Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol 2000; 95: 3503-6.
11. Pimentel M, Chow EJ, Lin HC. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study. Am J Gastroenterol 2003; 98: 412-9.
12. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006; 130: 1377-90.
13. Bratten JR, Spanier J, Jones MP. Lactulose breath testing does not discriminate patients with irritable bowel syndrome from healthy controls. Am J Gastroenterol 2008; 103: 958-63.
14. Yu D, Cheeseman F, Vanner S. Combined oro-caecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS. Gut 2011; 60: 334-40.
15. Connolly L, Chang L. Combined orocecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects orocecal transit, not small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gastroenterology 2011; 141: 1118-21.
16. Riordan SM, McIver CJ, Walker BM, Duncombe VM, Bolin TD, Thomas MC. The lactulose breath hydrogen test and small intestinal bacterial overgrowth. Am J Gastroenterol 1996; 91: 1795-803.
17. Miller MA, Parkman HP, Urbain JL, Brown KL, Donahue DJ, Knight LC, Maurer AH, Fisher RS. Comparison of scintigraphy and lactulose breath hydrogen test for assessment of orocecal transit: lactulose accelerates small bowel transit. Dig Dis Sci 1997; 42: 10-8.
18. Rao S, Lele V. Scintigraphy of the small intestine: a simplified standard for study of transit with reference to normal values. Eur J Nucl Med Mol Imaging 2002; 29: 971; author reply -2.
19. Zhao J, Fox M, Cong Y, Chu H, Shang Y, Fried M, Dai N. Lactose intolerance in patients with chronic functional diarrhoea: the role of small intestinal bacterial overgrowth. Aliment Pharmacol Ther 2010; 31: 892-900.
20. Pimentel M, Lembo A, Chey WD, Zakko S, Ringel Y, Yu J, Mareya SM, Shaw AL et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med 2011; 364: 22-32.
21. Anderson IH, Levine AS, Levitt MD. Incomplete absorption of the carbohydrate in all-purpose wheat flour. N Engl J Med 1981; 304: 891-2.
22. Thompson DG, Binfield P, De Belder A, O'Brien J, Warren S, Wilson M. Extra intestinal influences on exhaled breath hydrogen measurements during the investigation of gastrointestinal disease. Gut 1985; 26: 1349-52.
23. Bonapace ES, Maurer AH, Davidoff S, Krevsky B, Fisher RS, Parkman HP. Whole gut transit scintigraphy in the clinical evaluation of patients with upper and lower gastrointestinal symptoms. Am J Gastroenterol 2000; 95: 2838-47.
24. Posserud I, Stotzer PO, Bjornsson ES, Abrahamsson H, Simren M. Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut 2007; 56: 802-8.
25. Read NW, Al-Janabi MN, Bates TE, Holgate AM, Cann PA, Kinsman RI, McFarlane A, Brown C. Interpretation of the breath hydrogen profile obtained after ingesting a solid meal containing unabsorbable carbohydrate. Gut 1985; 26: 834-42.
26. Drossman DA, Dumitrascu DL. Rome III: new standard for functional gastrointestinal disorders. J Gastrointestin Liver Dis 2006; 15: 237-41.
27. Peralta S, Cottone C, Doveri T, Almasio PL, Craxi A. Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: experience with Rifaximin. World J Gastroenterol 2009; 15: 2628-31.
28. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-74.
29. Gibson PR, Barrett JS. The concept of small intestinal bacterial overgrowth in relation to functional gastrointestinal disorders. Nutrition 2010; 26: 1038-43.
30. Reddymasu SC, Sostarich S, McCallum RW. Small intestinal bacterial overgrowth in irritable bowel syndrome: are there any predictors? BMC Gastroenterol 2010; 10: 23.
31. Ford AC, Spiegel BM, Talley NJ, Moayyedi P. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2009; 7: 1279-86.
32. McMichael HB. Intestinal absorption of carbohydrates in man. Proc Nutr Soc 1971; 30: 248-54.
33. Caride VJ, Prokop EK, Troncale FJ, Buddoura W, Winchenbach K, McCallum RW. Scintigraphic determination of small intestinal transit time: comparison with the hydrogen breath technique. Gastroenterology 1984; 86: 714-20.
34. Sciarretta G, Furno A, Mazzoni M, Garagnani B, Malaguti P. Lactulose hydrogen breath test in orocecal transit assessment. Critical evaluation by means of scintigraphic method. Dig Dis Sci 1994; 39: 1505-10.
35. Ternent CA, Thorson AG, Blatchford GJ, Christensen MA, Thompson JS, Lanspa SJ, Adrian TE. Mouth to pouch transit after restorative proctocolectomy: hydrogen breath analysis correlates with scintigraphy. Am J Gastroenterol 2001; 96: 1460-3.
36. Gryback P, Jacobsson H, Blomquist L, Schnell PO, Hellstrom PM. Scintigraphy of the small intestine: a simplified standard for study of transit with reference to normal values. Eur J Nucl Med Mol Imaging 2002; 29: 39-45.
37. Hirakawa M, Iida M, Kohrogi N, Fujishima M. Hydrogen breath test assessment of orocecal transit time: comparison with barium meal study. Am J Gastroenterol 1988; 83: 1361-3.
38. Serra J, Azpiroz F, Malagelada JR. Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome. Gut 2001; 48: 14-9.
39. Zhao Y, Zou D, Wang R, Ma X, Yan X, Man X, Gao L, Fang J et al. Dyspepsia and irritable bowel syndrome in China: a population-based endoscopy study of prevalence and impact. Aliment Pharmacol Ther 2010; 32: 562-72.
40. Pimentel M, Mayer AG, Park S, Chow EJ, Hasan A, Kong Y. Methane production during lactulose breath test is associated with gastrointestinal disease presentation. Dig Dis Sci 2003; 48: 86-92.