Estimation of small intestinal bacterial overgrowth in children patients with different gastrointestinal symptoms

Dong Xi, Roger Kim, Yatian Zhang, Fernanda Kupferman, Radha Nathan


Background: Small intestinal bacterial overgrowth (SIBO) is a condition presenting with increased bacterial colonization. Lactulose breath test (LBT) is widely used for the diagnosis of SIBO. However the clinical symptom most likely to have positive LBT is still unknown. The objective of the study was to analyze the correlation between different gastrointestinal (GI) symptoms and positive LBT, and identify the symptom with highest positive LBT rate.

Methods: Retrospective study was performed in pediatric patients who underwent LBT from 2011 to 2014. Patients presented with one or multiple GI symptoms. LBT was performed and considered to be positive if hydrogen level was increased by 20ppm. The percentage of positive LBT in all the patients and patients with individual GI symptom was calculated. The symptom with highest positive LBT rate was identified.

Results: Totally 48 patients were tested. 34 patients (71%) were found to have positive LBT and 14 patients (29%) were negative. LBT was found to be positive in 85% of patients with failure to thrive, higher than other GI symptoms. Failure to thrive was identified to have highest positive LBT rate and less likely to be associated with multiple manifestations in patient with SIBO.

Conclusions: Our study showed strong correlation between positive LBT and failure to thrive, and less association of failure to thrive with multiple symptoms in SIBO. LBT should be considered in patients with failure to thrive and no other etiologies.



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