J Korean Med Sci.  2017 Jun;32(6):948-953. 10.3346/jkms.2017.32.6.948.

Obesity Is Inversely Related to Hydrogen-Producing Small Intestinal Bacterial Overgrowth in Non-Constipation Irritable Bowel Syndrome

Affiliations
  • 1Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea. ktwonm@hanmail.net

Abstract

There have been inconsistent findings on the association of obesity and non-constipation irritable bowel syndrome (IBS). Small intestinal bacterial overgrowth (SIBO) with hydrogen (Hâ‚‚) gas forming-microflora causes non-constipation IBS. But, the effect of Hâ‚‚ producing SIBO on obesity in non-constipation IBS patients has not been studied yet. The aim of this study was to investigate the association between obesity and SIBO in non-constipation IBS patients. We reviewed the charts of patients who showed IBS symptoms along with the documented results of their lactulose hydrogen breath test (LHBT) for SIBO. Multivariate models were used to assess the association between obesity and SIBO. Four-hundred fifty-eight patients were retrospectively included in the study. Of the 485 IBS patients, 158 (30.7%) subjects had positive results for LHBT. Subjects without SIBO showed significantly higher levels of body mass index (24.8 vs. 23.3; P < 0.001) and waist circumference (86.5 vs. 82.7; P < 0.001) as compared to subjects with SIBO. In multivariate analysis, the odds ratios of SIBO were 0.396 (P = 0.018) for obesity and 0.482 (P = 0.021) for abdominal obesity. This is the first human study to demonstrate that obesity is inversely related to SIBO with H2 gas production in non-constipation IBS patients.

Keyword

Small Intestinal Bacterial Overgrowth; Lactulose Hydrogen Breath Test; Obesity

MeSH Terms

Body Mass Index
Breath Tests
Humans
Hydrogen
Irritable Bowel Syndrome*
Lactulose
Multivariate Analysis
Obesity*
Obesity, Abdominal
Odds Ratio
Retrospective Studies
Waist Circumference
Hydrogen
Lactulose

Figure

  • Fig. 1 Flow chart of study design. IBS-C = constipation-predominant irritable bowel syndrome, GI = gastrointestinal, IBS = irritable bowel syndrome, SIBO = small intestinal bacterial overgrowth.


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