title: Erosive esophagitis may be related to small intestinal bacterial overgrowth.
abstract: OBJECTIVE
  Erosive esophagitis (EE) may be related to small intestinal bacterial overgrowth (SIBO) because gastro-esophageal reflux disease has been a comorbid condition of irritable bowel syndrome (IBS), which has been associated with SIBO. We conducted a pilot study to investigate whether EE was associated with SIBO.
  
  
  METHODS
  Twenty-eight patients with EE according to the Los Angeles classification criteria and 29 sex- and age-matched subjects without EE were enrolled. All subjects underwent esophagogastroduodenoscopy and a lactulose hydrogen breath test. A peak of H₂ values >20 ppm above the basal value after 10 g of lactulose ingestion was considered abnormal and suggestive of SIBO.
  
  
  RESULTS
  Abnormal lactulose hydrogen breath test results were found in 67% of EE patients, as compared with 37% in the control group; the difference was statistically significant (p = 0.024). Among the subjects without IBS, subjects with EE and controls had 65% and 31% abnormal lactulose hydrogen breath test results, respectively; the difference was also statistically significant (p = 0.032).
  
  
  CONCLUSIONS
  Subjects with EE had a higher prevalence of SIBO, as assessed by the lactulose hydrogen breath test, with respect to a control group. These findings may suggest that EE is associated with SIBO.
authors.affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Bom-Taeck
authors.initials: BT
authors.lastname: Kim
authors.forename: Duck-Joo
authors.initials: DJ
authors.lastname: Lee
authors.forename: Sat-Byul
authors.initials: SB
authors.lastname: Park
authors.forename: Nam-Seok
authors.initials: NS
authors.lastname: Joo
authors.forename: Young-Sang
authors.initials: YS
authors.lastname: Kim
authors.forename: Kyu-Nam
authors.initials: KN
authors.lastname: Kim
mesh_terms: D000328:Adult; D001944:Breath Tests; D016009:Chi-Square Distribution; D016145:Endoscopy, Digestive System; D004941:Esophagitis / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D007421:Intestine, Small / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000150:complications; D007792:Lactulose / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects
chemical_list: D007792:Lactulose; D006859:Hydrogen