title: Small intestinal bacterial overgrowth and lactose intolerance contribute to irritable bowel syndrome symptomatology in Pakistan.
abstract: BACKGROUND /AIM: The symptoms of irritable bowel syndrome resemble those of small intestinal bacterial overgrowth (SIBO). The aim of this study was to determine the frequency of SIBO and lactose intolerance (LI) occurrence in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) according to Rome III criteria.
  
  
  METHODS
  In this retrospective case-control study, patients over 18 years of age with altered bowel habit, bloating, and patients who had lactose Hydrogen breath test (H 2 BT) done were included. The "cases" were defined as patients who fulfill Rome III criteria for IBS-D, while "controls" were those having chronic nonspecific diarrhea (CNSD) who did not fulfill Rome III criteria for IBS-D. Demographic data, predominant bowel habit pattern, concurrent use of medications, etc., were noted.
  
  
  RESULTS
  Patients with IBS-D were 119 (51%) with a mean age of 35 ± 13 years, while those with CNSD were 115 (49%) with mean age 36 ± 15 years. Patients in both IBS-D and CNSD were comparable in gender, with male 87 (74%) and female 77 (64%). SIBO was documented by lactose H₂BT in 32/234 (14%) cases. It was positive in 22/119 (19%) cases with IBS-D, while 10/115 (9%) cases had CNSD (P = 0.03). LI was positive in 43/234 (18%) cases. Of these, 25/119 (21%) cases had IBS-D and 18/115 (16%) cases had CNSD (P = 0.29).
  
  
  CONCLUSIONS
  SIBO was seen in a significant number of our patients with IBS-D. There was no significant age or gender difference in patients with or without SIBO.
authors: Department of Medicine, The Aga Khan University, Karachi, Pakistan. yakoobjaved@hotmail.com
authors: Javed
authors: J
authors: Yakoob
authors: Zaigham
authors: Z
authors: Abbas
authors: Rustam
authors: R
authors: Khan
authors: Saeed
authors: S
authors: Hamid
authors: Safia
authors: S
authors: Awan
authors: Wasim
authors: W
authors: Jafri
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000388:Air / Q000032:analysis; D001419:Bacteria / Q000254:growth & development* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D001944:Breath Tests; D045853:Exhalation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D015994:Incidence; D007421:Intestine, Small / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D007787:Lactose Intolerance / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
chemical_list: D006859:Hydrogen