Erosive esophagitis SIBO.pdf

Scandinavian Journal of Gastroenterology. 2012; 47: 493–498 ORIGINAL ARTICLE Erosive esophagitis may be related to small intestinal bacterial overgrowth KWANG-MIN KIM, BOM-TAECK KIM, DUCK-JOO LEE, SAT-BYUL PARK, NAM-SEOK JOO, YOUNG-SANG KIM KYU-NAM KIM Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea Abstract Objectives. Erosive esophagitis (EE) may be related to small intestinal bacterial overgrowth (SIBO) because gastro- esophageal reflux disease has been a comorbid condition of irritable bowel syndrome (IBS), which has been associated with SIBO. We conducted a pilot study to investigate whether EE was associated with SIBO. Material and methods. Twenty-eight patients with EE according to the Los Angeles classification criteria and 29 sex- and age-matched subjects without EE were enrolled. All subjects underwent esophagogastroduodenoscopy and a lactulose hydrogen breath test. A peak of H2 values 20 ppm above the basal value after 10 g of lactulose ingestion was considered abnormal and suggestive of SIBO. Results. Abnormal lactulose hydrogen breath test results were found in 67% of EE patients, as compared with 37% in the control group; the difference was statistically significant (p = 0.024). Among the subjects without IBS, subjects with EE and controls had 65% and 31% abnormal lactulose hydrogen breath test results, respectively; the difference was also statistically significant (p = 0.032).Conclusions. Subjects with EE had a higher prevalence of SIBO, as assessed by the lactulose hydrogen breath test, with respect to a control group. These findings may suggest that EE is associated with SIBO. Key Words: erosive esophagitis, lactulose hydrogen breath test, small intestinal bacterial overgrowth Introduction Gastro-esophageal reflux disease (GERD) is defined as the reflux of gastroduodenal contents to the esoph- agus. The incidence of GERD is rapidly increasing. In Korea, GERD affects an estimated 3.5–