Irritable bowel syndrome and small intestinal bacterial.pdf

TOPIC HIGHLIGHT 2482 March 14, 2014|Volume 20|Issue 10|WJG| Online Submissions: /esps/ bpgoffice@ doi:10.3748/wjg.v20.i10.2482 World J Gastroenterol 2014 March 14; 20(10): 2482-2491 ISSN 1007-9327 (print) ISSN 2219-2840 (online) ? 2014 Baishideng Publishing Group Co., Limited. All rights reserved. Uday C Ghoshal, Deepakshi Srivastava, Department of Gas- troenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226104, India Author contributions: Ghoshal UC conceived, reviewed the data and wrote the manuscript; Srivastava D contributed to re- view of the data and writing of the manuscript. Correspondence to: Uday C Ghoshal, MD, DNB, DM, FACG, RFF, Professor, Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, India. udayghoshal@ Telephone: +91-522-249-4405 Fax: +91-522-2668017 Received: November 2, 2013 Revised: January 7, 2014 Accepted: February 17, 2014 Published online: March 14, 2014 Abstract Irritable bowel syndrome (IBS) is a common condi- tion characterized by abdominal pain or discomfort, bloating, and altered stool form and passage. Small intestinal bacterial overgrowth (SIBO) is a condition in which there is overgrowth of bacteria in small bowel in excess of 105 colony forming units per milliliter on culture of the upper gut aspirate. Frequency of SIBO varied from 4%-78% among patients with IBS and from 1%-40% among controls. Higher frequency in some studies might be due to fallacious criteria [post- lactulose breath-hydrogen rise 20 PPM above basal within 90 min (early-peak)]. Glucose hydrogen breath test (GHBT) has a low sensitivity to diagnose SIBO. Hence, studies based on GHBT might have under-esti- mated frequency of SIBO. Therefore, it is important to analyze these studies carefully to evaluate whether the reported association between IBS and SIBO is over or under-projected. This review evaluates studies on as- sociation between SIB