Korean J Gastroenterol.  2010 Oct;56(4):242-248. 10.4166/kjg.2010.56.4.242.

Usefulness of Lactulose Breath Test for the Prediction of Small Intestinal Bacterial Overgrowth in Irritable Bowel Syndrome

• Park JS
• Yu JH
• Lim HC
• Kim JH
• Yoon YH
• Park HJ
• Lee SI

• KMID: 1718360
• DOI: http://doi.org/10.4166/kjg.2010.56.4.242

Abstract

BACKGROUND/AIMS
Lactulose breath test (LBT) has been used as a presumptive surrogate marker for small intestinal bacterial overgrowth (SIBO). However, recent reports suggest that abnormal LBT cannot discriminate patients with irritable bowel syndrome (IBS) from the control. Thus, the aim of this study was to evaluate the usefulness of LBT in IBS.
METHODS
LBT from 76 IBS patients, 70 functional bowel disorders (FBD), and 40 controls were examined. LBT was considered positive if (1) baseline breath hydrogen (H2) >20 parts per million (ppm) or rise of breath H2 >20 ppm above the baseline in <90 mins, or (2) baseline breath methane (CH4) >10 ppm or rise of breath CH4 >10 ppm above the baseline in <90 mins. The subjects were categorized into predominant hydrogen producers (PHP), predominant methane producers (PMP), combined producer, and both negative group based on LBT.
RESULTS
The rate of abnormal LBT in the IBS, FBD, and control group were 44.7%, 41.4%, and 40.0% respectively without significant differences. The rate of PHP or PMP was not significantly different among the IBS, FBD, and control group. When clinical characteristics were analyzed in IBS and FBD according to LBT types, IBS subtypes and symptoms were not significantly different.
CONCLUSIONS
LBT was not useful to discriminate IBS/FBD patients from the control. The assessment of SIBO by LBT in IBS should be revalidated in the future.

Keyword

Irritable bowel syndrome; Small intestinal bacterial overgrowth; Lactulose breath test

MeSH Terms

Adult
Breath Tests/*methods
Diagnosis, Differential
Female
Humans
Intestine, Small/*microbiology
Irritable Bowel Syndrome/*diagnosis
Lactulose/*diagnostic use
Male
Middle Aged
Predictive Value of Tests

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