title: Small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome: frequency and predictors.
abstract: OBJECTIVE
  Small intestinal bacterial overgrowth (SIBO) has been implicated in pathogenesis of IBS. We aimed to study frequency and predictors of SIBO in patients with IBS.
  
  
  METHODS
  We included 59 consecutive patients of IBS & 37 healthy controls (HC). Evaluation for SIBO was done by glucose breath test (GBT) using 100 gm of glucose after an overnight fast. Breath hydrogen & methane concentration were noted at baseline & every 15 min after administration of glucose for a total of 3 h. Persistent rise in breath hydrogen or methane > 12 ppm above basal was considered diagnostic of SIBO.
  
  
  RESULTS
  Of 59 patients, 27 were diarrhoea predominant (D-IBS), 11 were constipation predominant (C-IBS) and 21 were mixed type (M-IBS). Median age of patients (34 [18-47] years) were comparable to controls (35 [20-48] years) (P = 0.21). Patient group was similar to HC in gender distribution (male 41/59 [69.5%]vs 25/37 [67.6%], P = 0.36). SIBO was more frequent in patients with IBS than HC (14/59 [23.7%]vs 1/37 [2.7%], P = 0.008). Patients with D-IBS more often had SIBO as compared to non-D-IBS (10/27 [37%]vs 4/32 [12.5%], P = 0.02). C-IBS had lowest frequency of SIBO (1/11 [9%]) among all IBS subgroups. Patients with history of bloating more often had SIBO as compared to those without this symptom (11/23 [47.8%]vs 3/36 [8.3%], P = 0.002). Among IBS patients, females more often had SIBO as compared to males (8/18 [44.4%]vs 6/41 [14.6%], P = 0.01).
  
  
  CONCLUSIONS
  SIBO was more frequent in patients with IBS as compared to healthy controls. D-IBS subtype, female gender & bloating were predictors of SIBO in patients with IBS.
authors: Department of Gastroenterology, GB Pant Hospital, New Delhi, India. sanjeevgastro@rediffmail.com
authors: Sanjeev
authors: S
authors: Sachdeva
authors: Ajit Kumar
authors: AK
authors: Rawat
authors: Ravi Sankar
authors: RS
authors: Reddy
authors: Amarender Singh
authors: AS
authors: Puri
mesh_terms: D000293:Adolescent; D000328:Adult; D001944:Breath Tests; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003248:Constipation / Q000382:microbiology; D003967:Diarrhea / Q000382:microbiology; D005260:Female; D006801:Humans; D007194:India; D007421:Intestine, Small / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult