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2009 | 56 | 4 |

Tytuł artykułu

Small intestine bacterial overgrowth is frequent in cystic fibrosis: combined hydrogen and methane measurements are required for its detection

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
 Introduction: Hydrogen breath test (BT) is commonly used as a diagnostic tool for the detection of small intestine bacterial overgrowth (SIBO). It was reported that colonic methane production is far more frequent in cystic fibrosis (CF) patients than in other subjects. Therefore, measuring exclusively hydrogen in the diagnostic breath test for diagnosing SIBO might be of limited value. We aimed to assess the usefulness of combined measurement of hydrogen and methane expiration for the diagnosis of SIBO in CF. Material and Methods: The study comprised 62 CF patients aged 5 to 18 years. Three-hundred-ninety subjects assessed due to gastrointestinal symptoms for the presence of SIBO served as a comparative group. In all subjects hydrogen/methane BT using glucose was performed. A positive BT was defined as fasting hydrogen ≥ 20 ppm or fasting methane ≥ 10 ppm or a rise of ≥ 12 ppm hydrogen or ≥ 6 ppm methane over baseline during the test. Results: In 23 (37.1%) CF patients and in 52 (13.3%) subjects from the comparative group abnormal BT results were found. In seven (11.3%) CF patients and 29 (7.4%) of the other subjects studied methane measurement allowed diagnosis of SIBO. Conclusions: Small intestine bacterial overgrowth is frequent in cystic fibrosis. For its detection in cystic fibrosis and other gastrointestinal patients, combined hydrogen and methane measurement instead of hydrogen breath test should be applied. Without the additional measurement of methane a significant percentage of SIBO will be missed.

Wydawca

-

Rocznik

Tom

56

Numer

4

Opis fizyczny

p.631-634,ref.

Twórcy

autor
  • Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
autor
autor

Bibliografia

  • Borowitz L, Durie PR, Clarke LL, Werlin SL, Taylor CJ, Semler J, De Lisle RC, Lewindon P, Lichtman SM, Sinaasappel M, Baker RD, Baker SS, Verkade HJ, Lowe ME, Stallings VA, Janghorbani M, Butler R, Heubi J (2005) Gastrointestinal outcomes and confounders in cystic fibrosis. J Pediatr Gastroenterol Nutr 41: 273-285. 
  • Bruzzesse E, Raia V, Gaudiello G, Polito G, Buccigrossi V, Formicola V, Guarino A (2004) Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration. Aliment Pharmacol Ther 20: 813-819. 
  • Bruzzesse E, Raia V, Spagnuolo MI, Volpicceli M, De Marco G, Maiuri L, Guarino A (2007) Effect of Lactobacillus GG supplementation on pulmonary exacerbations in patients with cystic fibrosis: a pilot study. Clin Nutr 26: 322-328. 
  • Bujanover Y, Peled Y, Blau H, Yahav J, Katznelson D, Gilat T (1987) Methane production in patients with cystic fibrosis. J Pediatr Gastroenterol Nutr 6: 377-380. 
  • Clarke LL, Gawenis LR, Bradford EM, Judd LM, Boyle KT, Simpson JE, Shull GE, Tanabe H, Ouellette AJ, Franklin CL, Walker NM (2004) Abnormal Paneth cell granule dissolution and compromised resistance to bacterial colonization in the intestine of CF mice. Am J Physiol Gastrointest Liver Physiol 286: 1050-1058. 
  • Fridge JL, Conrad C, Gerson L, Castillo RO, Cox K (2007) Risk factors for small bowel bacterial overgrowth in cystic fibrosis. J Pediatr Gastroenterol Nutr 44: 212-218. 
  • Husebye E (2005) The pathogenesis of gastrointestinal bacterial overgrowth. Chemotherapy 51: (Suppl 1) 1-22.  
  • Kamińska B, Landowski P, Bogotko M, Szarszewski A, Korzon M (2002) The incidence of breath methane population in children and youth from Gdańsk City. Pediatria Współczesna 4: 265-267 (in Polish).
  • Kerckhoffs AP, Visser MR, Samsom M, van der Rest ME, de Vogel J, Harmsen W, Akkermans LM (2008) Critical evaluation of diagnosing bacterial overgrowth in the proximal small intestine. J Clin Gastroenterol 42: 1095-1102. 
  • Lewindon PJ, Robb TA, Moore DJ, Davidson GP, Martin AJ (1998) Bowel dysfunction in cystic fibrosis: importance of breath testing. J Paediatr Child Health 34: 79-82. 
  • Miller TL, Wolin MJ (1982) Enumeration of methanobrevibacter Smithii in human feces. Arch Microbiol 131: 14-18. 
  • Norkina O, Burnett DG, De Lisle RC (2004) Bacterial overgrowth in cystic fibrosis transmembrane conductance regulator null mouse small intestine. Infect Immun 72: 6040-6049. 
  • Perman JA, Modler S (1982) Glycoproteins as substrates for production of hydrogen and methane by colonic bacterial flora. Gastroenterology 83: 388-393. 
  • Singh VV, Toskes PP (2003) Small bowel bacterial overgrowth: presentation, diagnosis and treatment. Curr Gastroenterol Rep 5: 365-372

Typ dokumentu

Bibliografia

Identyfikatory

Identyfikator YADDA

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