Small intestine bacterial overgrowth test

Devido ao maior custo e complexidade para a realizaГ§ГЈo do aspirado jejunal, padrГЈo ouro para o diagnГіstico da sГndrome, tem sido utilizado rotineiramente o teste do hidrogГЄnio (H 2 ) expirado, utilizando glicose ou lactulose como substrato, que Г© capaz de determinar, no ar expirado, a concentraГ§ГЈo de H 2 produzida a partir do metabolismo bacteriano intestinal. Os sintomas do supercrescimento bacteriano do intestino delgado sГЈo inespecГficos englobando quadro de dor/distensГЈo abdominal, diarreia e flatulГЄncia. O supercrescimento bacteriano do intestino delgado Г© uma sГndrome heterogГЄnea, caracterizada pelo aumento no nГєmero e/ou presenГ§a de uma microbiota atГpica no intestino delgado. The data found in this study is consistent with the findings of the current literature and underscores the need for using devices capable of capturing the two gases (exhaled H 2 and CH 4 ) to improve the sensitivity and hence the accuracy of small intestine bacterial overgrowth diagnosis in daily medical practice.Д«acterial growth Small intestine Breath tests Hydrogen Methane It found further that methane gas was alone responsible for positivity in 18% of patients. The results indicated a significant prevalence of small intestine bacterial overgrowth in the H 2 test and in the test of exhaled H 2 and CH 4 (56% and 64% respectively) in patients with gastrointestinal symptoms, and higher prevalence in females.

METHODSДЄ total of 200 patients of both sexes without age limitation were evaluated, being directed to a Breath Test Laboratory for performing the H 2 test (100 patients) and of exhaled H 2 and CH 4 (100 patients) due to gastrointestinal complaints, most of them patients with gastrointestinal functional disorders. This study aimed to determine the prevalence of small intestine bacterial overgrowth in patients with digestive symptoms, through a comparative analysis of breath tests of H 2 or H 2 and CH 4 associated, using glucose as substrate. However, due to a number of individuals presenting a methanogenic microbiota, which does not produce H 2, the testing on devices capable of detecting, concurrently, the concentration of exhaled H 2 and methane (CH 4 ) is justified. Due to the increased cost and complexity for carrying out the jejunal aspirate, the gold standard for diagnosis of the syndrome, routinely the hydrogen (H 2 ) breath test has been used, utilizing glucose or lactulose as substrate, which is able to determine, in the exhaled air, the H 2 concentration produced from the intestinal bacterial metabolism. The symptoms of small intestine bacterial overgrowth are unspecific, encompassing abdominal pain/distension, diarrhea and flatulence. Diagnostic accuracy of hydrogen breath testing in SIBO can be maximized by careful patient selection for testing, proper test preparation, and standardization of test performance as well as test interpretation.Small intestine bacterial overgrowth is a heterogeneous syndrome characterized by an increase in the number and/or the presence of atypical microbiota in the small intestine. The measurement of methane in addition to hydrogen can increase the sensitivity of breath testing for SIBO. Lactose, fructose, and sorbitol should not be used as substrates in the assessment of suspected SIBO. Carbohydrates such as lactulose and glucose are the most widely used substrates in hydrogen breath testing, with glucose arguably providing greater testing accuracy.

Although not without shortcomings, hydrogen breath testing provides the simplest noninvasive and widely available diagnostic modality for suspected SIBO. The current gold standard, small-bowel aspiration and quantitative culture, is limited by its high cost, invasive nature, lack of standardization, sampling error, and need for dedicated infrastructure. Unfortunately, no perfect test exists for the diagnosis of SIBO. Ideally, an accurate and objective diagnosis of SIBO should be established before initiating antibiotic treatment. The diagnosis of small intestinal bacterial overgrowth (SIBO) has increased considerably owing to a growing recognition of its association with common bowel symptoms including chronic diarrhea, bloating, abdominal distention, and the irritable bowel syndrome.

Small intestine bacterial overgrowth test