Small intestinal bacterial overgrowth and low-grade systemic inflammation in 50 patients with irritable bowel syndrome / 中华消化杂志

ABSTRACT

Objective To investigate the incidence of small intestinal bacterial overgrowth (SIBO) and systemic low-grade inflammation in patients with irritable bowel syndrome (IBS ) .Methods From June to October in 2017 ,50 cases of IBS patients who met Rome Ⅳ criteria were consecutively collected at Outpatient Department of Gastroenterology of Shanghai Huashan Hospital .The incidence of SIBO was detected by hydrogen lactulose breath test (LBT) and methane LBT .The incidence of systemic low-grade inflammation in IBS patients was determined by fractional exhaled nitric oxide (FeNO) breath test .Chi-square test was used for statistical analysis .Results Among 50 IBS patients ,the positive rate of FeNO was 70％ (35/50) ,and the number of FeNO positive cases in diarrhea-predominant (n=28) ,constipation-predominant (n= 14) and mix-type (n= 8) IBS paitents was 18 ,11 and six ,respectively ,and the difference was not statistically significant among three groups (χ2=1 .020 ,P=0 .600) .The incidence rate of SIBO was 60％ (30/50) ,with 20 cases (40％ ) being only positive for hydrogen LBT ,seven cases (14％ ) being methane LBT ,and three cases (6％ ) being both positive .The numbers of hydrogen LBT and methane LBT in diarrhea-predominant ,constipation-predominant ,and mix-type IBS patents were 17 , three ,three and two ,six ,two ,respectively .There were statistically significant differences in positive rates of hydrogen LBT and methane LBT among three groups (χ2 =6 .076 and 6 .392 ,both P<0 .05) . The positive rate of FeNO in IBS patients with SIBO was higher than that of IBS patients without SIBO (90％ ,27/30 vs .40％ ,8/20) ,and the difference was statistically significant (χ2 =14 .286 ,P<0 .01) . Conclusions Combination of hydrogen LBT and methane LBT has a higher detection rate of SIBO than traditional single hydrogen LBT . There is a correlation between SIBO and systemic low-grade inflammation in IBS patients .