The ursodeoxycholic acid-p-aminobenzoic acid deconjugation test, a new tool for the diagnosis of bacterial overgrowth syndrome.
OBJECTIVE
To determine the possible complementary role of the ursodeoxycholic acid-p-aminobenzoic acid (UDCA-PABA) loading test in the diagnosis of intestinal bacterial overgrowth.


METHODS
A prospective clinical study.


METHODS
The hydrogen breath and UDCA-PABA tests were performed simultaneously in 68 patients with suspected contaminated small bowel syndrome (CSBS), and in 10 healthy control subjects. The hydrogen breath test was performed by oral loading of 25 g of lactose and/or 10 g of lactulose. The UDCA-PABA test was carried out by oral loading of 250 mg of UDCA-PABA conjugate, followed by measurement of the amount of PABA excreted in the urine. The diagnosis of bacterial overgrowth was considered to be established when either the hydrogen breath test or the UDCA-PABA test produced abnormal results.


RESULTS
Thirty-five of the 68 patients proved to have CSBS. In 13 of these 35 patients, only the enhanced urinary PABA excretion (11.7 +/- 1.42 mg vs. 3.6 +/- 0.68 mg) indicated bacterial overgrowth, 15 of the 35 patients gave only a positive hydrogen breath test, and in the remaining seven cases the results of both tests were abnormal. In eight CSBS patients, the urinary excretion of PABA was decreased significantly following 10-day tinidazole treatment (5.5 +/- 1.29 mg vs. 13.1 +/- 2.07 mg).


CONCLUSIONS
The UDCA-PABA test is a valuable clinical method for the detection of bacterial overgrowth, especially in cases where hydrogen production alone fails to reveal CSBS. It is also a useful procedure for evaluating the efficacy of antibacterial treatment.
Kiss
Z F
ZF
First Department of Medicine, Albert Szent-Györgyi Medical University, Szeged, Hungary.
Wölfling
J
J
Csáti
S
S
Nagy
F
F
Wittmann
T
T
Schneider
G
G
Lonovics
J
J
D010129:4-Aminobenzoic Acid / Q000008:administration & dosage* / Q000652:urine*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001944:Breath Tests; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000382:microbiology* / Q000652:urine; D007785:Lactose / Q000008:administration & dosage; D007792:Lactulose / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage*
D007792:Lactulose; D014580:Ursodeoxycholic Acid; D006859:Hydrogen; D007785:Lactose; D010129:4-Aminobenzoic Acid