Abnormal Breath Testing in IBS: A Meta-Analysis

  title={Abnormal Breath Testing in IBS: A Meta-Analysis},
  author={Eric D. Shah and Robert J. Basseri and Kelly Chong and Mark Pimentel},
  journal={Digestive Diseases and Sciences},
BackgroundRecent evidence suggests a role for enteric bacteria in the development of symptoms in subjects with irritable bowel syndrome (IBS). The concept was initially based on the common finding of an abnormal lactulose breath test to suggest the presence of small intestinal bacterial overgrowth (SIBO). Despite successful antibiotic studies based on these findings, the premise of bacterial overgrowth was met with skepticism due to the perceived inaccuracies of breath testing in humans. In… 

Molecular assessment of differences in the duodenal microbiome in subjects with irritable bowel syndrome

16S rDNA sequencing confirms microbial overgrowth in the small bowel in IBS, with a concomitant reduction in diversity, and qPCR supports alterations in specific microbial populations in Ibs.

Methane on Breath Testing Is Associated with Constipation: A Systematic Review and Meta-analysis

It is demonstrated that methane present on breath testing is significantly associated with constipation in both IBS and functional constipation, and methane may be used to identify candidates for antibiotic treatment of constipation.

Small Intestinal Bacterial Overgrowth in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies.

A systematic review and meta-analysis of studies reporting SIBO prevalence in patients with irritable bowel syndrome and controls suggests a link between IBS and SIBO, but the overall quality of the evidence is low.

The Prevalence of Overgrowth by Aerobic Bacteria in the Small Intestine by Small Bowel Culture: Relationship with Irritable Bowel Syndrome

Using culture of the small bowel, SIBO by aerobe bacteria is independently linked with IBS, reinforcing results of clinical trials evidencing a therapeutic role of non-absorbable antibiotics for the management of IBS symptoms.

Breath Test or Duodenal Aspirate for Small Intestinal Bacterial Overgrowth: Still No Breath of Fresh Air

  • E. Shah
  • Medicine
    Digestive Diseases and Sciences
  • 2020
Breath testing is more likely the preferred routine option to evaluate for SIBO in clinical practice as a noninvasive, low-cost test, compared with duodenal aspirates obtained during a routine upper endoscopy.

Questioning the bacterial overgrowth hypothesis of irritable bowel syndrome: an epidemiologic and evolutionary perspective.

  • B. Spiegel
  • Medicine
    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2011

Usefulness of the hydrogen breath test in patients with functional dyspepsia

Quantitative and/or qualitative changes in the gut microbiota may be the cause of functional dyspepsia.

Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy

A recent proof-of-concept study showing the high frequency of symptom improvement in patients with IBS with SIBO further supports the hypothesis that gut dysbiosis, including small intestinal bacterial overgrowth, causes IBS symptoms.



Lactulose Breath Testing Does Not Discriminate Patients With Irritable Bowel Syndrome From Healthy Controls

The majority of patients with IBS and healthy subjects meet criteria for an “abnormal” LBT using previously published test criteria, and groups are not discriminated using this diagnostic method, and the utility of LBT, in its current form as a diagnostic tool in IBS requires critical reappraisal.

Evaluating Breath Methane as a Diagnostic Test for Constipation-Predominant IBS

Methane is a potential diagnostic test for the identification of C-IBS and may guide treatment in subjects and physicians.

Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis.

A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing

In contrast with IBS, the degree of abnormality on breath test is greater in subjects with fibromyalgia and correlates with somatic pain, which is not dependent on the higher prevalence of an abnormal breath test.

Methane Production During Lactulose Breath Test Is Associated with Gastrointestinal Disease Presentation

A methane positive breath test is associated with constipation as a symptom in IBS and IBD and was almost nonexistent in the predominantly diarrheal conditions of Crohn's and UC.

Detection of Bacterial Overgrowth in IBS Using the Lactulose H2 Breath Test: Comparison with 14C-d-Xylose and Healthy Controls

The lactulose breath test did not reliably detect a common association between bacterial overgrowth and IBS in the patient population of Rome II positive IBS patients and compared it to the 14C-d-xylose Breath test, a test with acknowledged greater specificity for bacterial over growth.

Positive Glucose Breath Testing is More Prevalent in Patients With IBS-like Symptoms Compared With Controls of Similar Age and Gender Distribution

GBT is useful to identify a subgroup of IBS-like patients, whose symptoms are owing to SIBO, and normalization of GBT after antibiotic therapy is associated with a significant improvement of symptoms.

Small intestinal bacterial overgrowth in irritable bowel syndrome: association with colon motility, bowel symptoms, and psychological distress

  • M. GroverM. Kanazawa W. Whitehead
  • Medicine
    Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
  • 2008
The prevalence of SIBO in those with IBS and its association with colonic motility, bowel symptoms and psychological distress was determined and it is unlikely that SIBO is unlikely to contribute significantly to the pathogenesis of IBS.

Neomycin Improves Constipation-Predominant Irritable Bowel Syndrome in a Fashion That Is Dependent on the Presence of Methane Gas: Subanalysis of a Double-Blind Randomized Controlled Study

Treatment with neomycin improves constipation in C-IBS, and depends on the presence and elimination of methane on breath test, which is associated with improvement in constipation.