PMID- 18217406
OWN - NLM
STAT- MEDLINE
DCOM- 20080229
LR  - 20181201
IS  - 1896-1126 (Print)
IS  - 1896-1126 (Linking)
VI  - 52
DP  - 2007
TI  - Results of small intestinal bacterial overgrowth testing in irritable bowel 
      syndrome patients: clinical profiles and effects of antibiotic trial.
PG  - 139-42
AB  - PURPOSE: Small intestinal bacterial overgrowth (SIBO) may coexist with irritable 
      bowel syndrome (IBS) and eradication therapy has been reported as effective in 
      reducing IBS symptoms. Aims of this study were to: (1) Assess the clinical 
      profiles of IBS patients, who underwent breath testing with a glucose 
      substrate--glucose breath test (GBT); (2) Evaluate hydrogen and methane 
      parameters in various IBS groups; (3) Assess the role of inhibition of gastric 
      acid in contributing to SIBO; (4) Investigate efficacy and safety of 
      non-absorbable antibiotic rifamixin for eradication and symptom relief. METHODS: 
      204 IBS patients met the ROME II criteria for IBS (170F & 34M; mean age 46.4; 
      range 18-88) and underwent GBT. 8 of these patients with positive GBT were 
      treated with rifaximin 200 mg, 4 times a day for 1 month and symptom assessments 
      and GBT were repeated. RESULTS: 93 (46%) had a positive GBT. 68 (73%) of these 93 
      IBS-diarrhea dominant (IBS-D), 12 (13%) were constipation dominant (IBS-C) and 13 
      (14%) IBS with alternating bowel pattern. 48% of SIBO positive patients were 
      receiving PPI therapy compared to 40% of IBS patients with negative GBT. 61 (66%) 
      produced only hydrogen, 27 (29%) methane only, and 5 (5%) both-hydrogen and 
      methane. There were more methane producers in IBS-C then IBS-D group (58% vs 28%) 
      while IBS-D had more hydrogen formers (71% vs 42%). 8 patients with SIBO (7F & 
      IM; mean age 55, range 31-85) received rifamixin 800 mg/day. Repeat GBT was 
      normal in 6 (75%), 1 patient (12.5%) normalized according to hydrogen criteria 
      but methane remained positive. Symptoms score improved in 7 (87.5%) patients and 
      no adverse events were noted. CONCLUSIONS: (1) SIBO was present in nearly half of 
      this large cohort of IBS patients based on the results of GBT; (2) Chronic PPI 
      use was not associated with SIBO; (3) Methane formers on the GBT are more likely 
      to be constipated; (4) Rifaximin is effective in treatment of SIBO in IBS and 
      controlled trials are warranted.
FAU - Majewski, M
AU  - Majewski M
AD  - Department of Medicine, Division of Gastroenterology, University of Kansas 
      Medical Center, Kansas City, KS 66061, USA.
FAU - McCallum, R W
AU  - McCallum RW
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Netherlands
TA  - Adv Med Sci
JT  - Advances in medical sciences
JID - 101276222
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pumps)
RN  - 0 (Rifamycins)
RN  - IY9XDZ35W2 (Glucose)
RN  - L36O5T016N (Rifaximin)
RN  - OP0UW79H66 (Methane)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/*pharmacology
MH  - Breath Tests
MH  - Cohort Studies
MH  - Female
MH  - Glucose/metabolism
MH  - Humans
MH  - Intestine, Small/*metabolism/*microbiology
MH  - Irritable Bowel Syndrome/*metabolism
MH  - Male
MH  - Methane/chemistry
MH  - Middle Aged
MH  - Proton Pumps
MH  - Rifamycins/pharmacology
MH  - Rifaximin
EDAT- 2008/01/26 09:00
MHDA- 2008/03/01 09:00
CRDT- 2008/01/26 09:00
PHST- 2008/01/26 09:00 [pubmed]
PHST- 2008/03/01 09:00 [medline]
PHST- 2008/01/26 09:00 [entrez]
PST - ppublish
SO  - Adv Med Sci. 2007;52:139-42.