Title: Risk Factors for Small Intestinal Bacterial Overgrowth
Abstract: Purpose: Small intestinal bacterial overgrowth (SIBO) has been associated with various gastrointestinal disorders. Enteric bacterial flora are thought to play an important role in the pathogenesis of some gastrointestinal diseases. We aim to determine which patient characteristics, symptoms, and laboratory values are predictive of SIBO as defined by a positive glucose breath test. Methods: The records of all patients who were referred for a glucose breath test between January 1, 2003, and December 31, 2006, were analyzed retrospectively. Breath samples were analyzed for hydrogen and methane using a Model DP Microlyzer (Quintron Instrument, Milwaukee, WI). A breath test was deemed positive when the baseline hydrogen or methane value increased by greater than 12 ppm after the ingestion of 50 g of glucose. Chi-square tests and Fisher's exact test were used to determine associations between categorical variables. The independent sample t-test was used to compare groups of continuous variables. Results: Of the 167 eligible patients who were referred for a glucose breath test, 139 patient records were available for analysis (49 male, 90 female; mean age 54 ± 13 years). There were 40 patients (29%) with positive breath tests. Patient characteristics that were significantly associated with a positive glucose breath test were: age greater than 75 years (P= 0.01), low serum albumin (P= 0.04), and a history of cirrhosis (P= 0.02). The OR for age greater than 75 was 4.7 (95% CI 1.4, 15.4). A history of irritable bowel syndrome significantly lowered the risk of a positive test (OR = 0.27, P= 0.02). There was no association between a positive breath test and the use of proton pump inhibitors, histamine-2 receptor antagonists or antimotility drugs. Diarrhea was significantly associated with a positive breath test by hydrogen criteria (OR 2.9, P= 0.01), but no similar association was found with constipation, abdominal pain, bloating or gas. Conclusion: In this patient cohort, advanced age, low albumin and a history of cirrhosis were significantly associated with a positive glucose breath test. Patients with IBS were less likely to have a positive breath test. Knowledge of the predisposing factors for SIBO might lead to earlier testing and treatment in some patients.
Publication Year: 2007
Publication Date: 2007-09-01
Language: en
Type: article
Indexed In: ['crossref']
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