Prevalence and Symptom Correlation of Abnormal Breath Hydrogen Tests in Patients with Irritable Bowel Syndrome

Laxmikant Desai, (2014) Prevalence and Symptom Correlation of Abnormal Breath Hydrogen Tests in Patients with Irritable Bowel Syndrome. Masters thesis, Christian Medical College, Vellore.


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INTRODUCTION: Irritable bowel syndrome (IBS) is defined as “a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit, and with features of disordered defecation”. IBS is a relapsing functional bowel disorder which is diagnosed based on criteria including symptoms in those without any detectable organic causes. It is the most common gastrointestinal disorder diagnosed and accounts for around 30 percent of all referrals to gastroenterologists. Previously diagnosis of IBS was made after exclusion of all organic causes. After the introduction of new and more precise clinical criteria, i.e. “Rome criteria”, it has allowed to make a diagnosis of IBS on the basis of symptoms alone without extensive evaluation. AIM / OBJECTIVES: To study the prevalence and symptom correlation of abnormal hydrogen breath test, as a marker of small intestinal bacterial overgrowth (SIBO), and to determine orocecal transit time (OCTT) in patients with irritable bowel syndrome (IBS). MATERIAL AND METHODS: Consecutive patients aged > 18 years with IBS as per Rome II criteria who attended Gastroenterology Outpatient Clinic of Christian Medical College, Vellore; between August 2012 and December 2013 were included. Patients who had taken antibiotics within last 4 weeks, on lactulose within 1 week or had any other cause for SIBO were excluded. Patients underwent glucose hydrogen breath test (HBT) and lactulose HBT on 2 consecutive days as per standard protocol using Bedfont Hydrogen Breath Analyser, UK. GHBT was used to study SIBO and LHBT was used to calculate OCTT.Analysis was done using Chi square, Fisher’s exact or ANOVA test as applicable with P value of <0.05 taken as significant. RESULTS: 194 patients were enrolled, of which 164 underwent both tests. Mean age was 39.16 (± 10.36) yrs and 113 (68.9%) were males. GHBT was abnormal in 12 (7.32%) – 7(10.4%) in IBS-D, 1(4.2%) in IBS-C and 4(5.3%) in IBS-I. Symptom of bloating correlated significantly (p=0.013) with abnormal GHBT. OCTT could not be calculated in 27 (16.5%) patients, OCTT was 114.3 (±25.3) min in all subjects together, 112.3(±25.9) in IBS-D, 122.8(±28.3) in IBS-C, and 112.8 (±24.8) in IBS-I. ANOVA test (p=0.255) did not show any difference in OCTT between subgroups of IBS. CONCLUSIONS: Prevalence of abnormal GHBT (a surrogate marker of SIBO) was 7.32%. The symptom of bloating significantly correlated with positive GHBT.OCTT was 115.1(±24.1) min. There was no statistical difference between OCTT in different subgroups of IBS.

Item Type: Thesis (Masters)
Additional Information: Reg.No.16112754
Uncontrolled Keywords: Irritable bowel syndrome (IBS), Small intestinal bacterial overgrowth (SIBO), Orocecal transit time (OCTT)
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 15 Jan 2020 16:01
Last Modified: 15 Jan 2020 16:01

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