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Erschienen in: Digestive Diseases and Sciences 6/2008

01.06.2008 | Original Paper

A Systematic Review of Diagnostic Tests for Small Intestinal Bacterial Overgrowth

verfasst von: Reza Khoshini, Sun-Chuan Dai, Sheila Lezcano, Mark Pimentel

Erschienen in: Digestive Diseases and Sciences | Ausgabe 6/2008

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Abstract

Background A growing number of studies seem to suggest that small intestinal bacterial overgrowth (SIBO) is a common clinical problem. Although various techniques are available to make this diagnosis, tradition has accepted small bowel aspirate (>105 cfu/ml) as a gold standard. In this systematic review, the validity of culture and other diagnostic testing for SIBO is evaluated. Methods We performed a systematic review of the literature from 1966 to present using electronic databases (PubMed and OVID). Full paper review of those abstracts that fulfilled preset criteria was carried out to evaluate the validity of various tests in diagnosing SIBO. Finally, all papers were evaluated against published standards for studies on diagnostic testing. Results Seventy-one papers met the criteria for detailed review. Studies were very heterogeneous with regards to patient populations, test definitions, sample size, and methods in general. Small bowel colony counts appeared elevated in most gastrointestinal diseases compared to controls. The traditional definition of >105 cfu/ml was usually indicative of stagnant loop conditions. Although, numerous diagnostic tests were studied, not even culture papers met the quality standards described by Reid et al. Breath testing and other diagnostic testing suffered therefore from the lack of a gold standard against which to validate in addition to the poor quality. Conclusions There is no validated diagnostic test or gold standard for SIBO. In this context, the most practical method to evaluate SIBO in studies at this time would be a test, treat, and outcome technique.
Literatur
1.
Zurück zum Zitat Hewetson JT (1904) Bacteriology of certain parts of human alimentary canal and of inflammatory processes arising therefrom. Brit M J 2:1457–1460PubMed Hewetson JT (1904) Bacteriology of certain parts of human alimentary canal and of inflammatory processes arising therefrom. Brit M J 2:1457–1460PubMed
2.
Zurück zum Zitat Bernhardt H, Knoke M (1989) Recent studies on the microbial ecology of the upper gastrointestinal tract. Infection 17(4):259–263PubMedCrossRef Bernhardt H, Knoke M (1989) Recent studies on the microbial ecology of the upper gastrointestinal tract. Infection 17(4):259–263PubMedCrossRef
3.
Zurück zum Zitat Yamada T, Alpers DH, Owyang C et al (eds) (2003) Textbook of gastroenterology. 4th ed. JB Lippincott, Philadelphia Yamada T, Alpers DH, Owyang C et al (eds) (2003) Textbook of gastroenterology. 4th ed. JB Lippincott, Philadelphia
4.
Zurück zum Zitat Di Stefano M, Miceli E, Missanelli A, Mazzocchi S, Corazza GR (2005) Absorbable vs. non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome. Aliment Pharmacol Ther 21(8):985–992PubMedCrossRef Di Stefano M, Miceli E, Missanelli A, Mazzocchi S, Corazza GR (2005) Absorbable vs. non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome. Aliment Pharmacol Ther 21(8):985–992PubMedCrossRef
5.
Zurück zum Zitat King CE, Toskes PP (1979) Small intestine bacterial overgrowth. Gastroenterology 76(5 Pt 1):1035–1055PubMed King CE, Toskes PP (1979) Small intestine bacterial overgrowth. Gastroenterology 76(5 Pt 1):1035–1055PubMed
6.
Zurück zum Zitat Drenick EJ, Fisler J, Johnson D (1982) Hepatic steatosis after intestinal bypass–prevention and reversal by metronidazole, irrespective of protein-calorie malnutrition. Gastroenterology 82(3):535–548PubMed Drenick EJ, Fisler J, Johnson D (1982) Hepatic steatosis after intestinal bypass–prevention and reversal by metronidazole, irrespective of protein-calorie malnutrition. Gastroenterology 82(3):535–548PubMed
7.
Zurück zum Zitat Kono K, Ohnishi K, Omata M, Saito M, Nakayama T, Hatano H, Nakajima Y, Sugita S, Okuda K (1988) Experimental portal fibrosis produced by intraportal injection of killed nonpathogenic Escherichia coli in rabbits. Gastroenterology 94(3):787–796PubMed Kono K, Ohnishi K, Omata M, Saito M, Nakayama T, Hatano H, Nakajima Y, Sugita S, Okuda K (1988) Experimental portal fibrosis produced by intraportal injection of killed nonpathogenic Escherichia coli in rabbits. Gastroenterology 94(3):787–796PubMed
8.
Zurück zum Zitat Lichtman SN, Keku J, Schwab JH, Sartor RB (1991) Hepatic injury associated with small bowel bacterial overgrowth in rats is prevented by metronidazole and tetracycline. Gastroenterology 100(2):513–519PubMed Lichtman SN, Keku J, Schwab JH, Sartor RB (1991) Hepatic injury associated with small bowel bacterial overgrowth in rats is prevented by metronidazole and tetracycline. Gastroenterology 100(2):513–519PubMed
9.
Zurück zum Zitat Henriksson AE, Blomquist L, Nord CE, Midtvedt T, Uribe A (1993) Small intestinal bacterial overgrowth in patients with rheumatoid arthritis. Ann Rheum Dis 52(7):503–510PubMedCrossRef Henriksson AE, Blomquist L, Nord CE, Midtvedt T, Uribe A (1993) Small intestinal bacterial overgrowth in patients with rheumatoid arthritis. Ann Rheum Dis 52(7):503–510PubMedCrossRef
10.
Zurück zum Zitat Pimentel M, Park S, Mirocha J, Kane SV, Kong Y (2006) The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial. Ann Intern Med 145(8):557–563PubMed Pimentel M, Park S, Mirocha J, Kane SV, Kong Y (2006) The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial. Ann Intern Med 145(8):557–563PubMed
11.
Zurück zum Zitat Pimentel M, Chow EJ, Lin HC (2003) Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. A double-blind, randomized, placebo-controlled study. Am J Gastroenterol 98(2):412–419PubMed Pimentel M, Chow EJ, Lin HC (2003) Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. A double-blind, randomized, placebo-controlled study. Am J Gastroenterol 98(2):412–419PubMed
12.
Zurück zum Zitat Sharara AI, Aoun E, Abdul-Baki H, Mounzer R, Sidani S, Elhajj I (2006) A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence. Am J Gastroenterol 101(2):326–333PubMedCrossRef Sharara AI, Aoun E, Abdul-Baki H, Mounzer R, Sidani S, Elhajj I (2006) A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence. Am J Gastroenterol 101(2):326–333PubMedCrossRef
13.
Zurück zum Zitat Funayama Y, Sasaki I, Naito H, Fukushima K, Shibata C, Masuko T, Takahashi K, Ogawa H, Sato S, Ueno T, Noguchi M, Hiwatashi N, Matsuno S (1999) Monitoring and antibacterial treatment for postoperative bacterial overgrowth in Crohn’s disease. Dis Colon Rectum 42(8):1072–1077PubMedCrossRef Funayama Y, Sasaki I, Naito H, Fukushima K, Shibata C, Masuko T, Takahashi K, Ogawa H, Sato S, Ueno T, Noguchi M, Hiwatashi N, Matsuno S (1999) Monitoring and antibacterial treatment for postoperative bacterial overgrowth in Crohn’s disease. Dis Colon Rectum 42(8):1072–1077PubMedCrossRef
14.
Zurück zum Zitat Reid MC, Lachs MS, Feinstein AR (1995) Use of methodological standards in diagnostic test research. Getting better but still not good. JAMA 274(8):645–651PubMedCrossRef Reid MC, Lachs MS, Feinstein AR (1995) Use of methodological standards in diagnostic test research. Getting better but still not good. JAMA 274(8):645–651PubMedCrossRef
15.
Zurück zum Zitat Bardhan PK, Gyr K, Beglinger C, Vogtlin J, Frey R, Vischer W (1992) Diagnosis of bacterial overgrowth after culturing proximal small-bowel aspirate obtained during routine upper gastrointestinal endoscopy. Scand J Gastroenterol 27(3):253–256PubMedCrossRef Bardhan PK, Gyr K, Beglinger C, Vogtlin J, Frey R, Vischer W (1992) Diagnosis of bacterial overgrowth after culturing proximal small-bowel aspirate obtained during routine upper gastrointestinal endoscopy. Scand J Gastroenterol 27(3):253–256PubMedCrossRef
16.
Zurück zum Zitat Bode JC, Bode C, Heidelbach R, Durr HK, Martini GA (1984) Jejunal microflora in patients with chronic alcohol abuse. Hepatogastroenterology 31(1):30–34PubMed Bode JC, Bode C, Heidelbach R, Durr HK, Martini GA (1984) Jejunal microflora in patients with chronic alcohol abuse. Hepatogastroenterology 31(1):30–34PubMed
17.
Zurück zum Zitat Omoike IU, Abiodun PO (1989) Upper small intestinal microflora in diarrhea and malnutrition in Nigerian children. J Pediatr Gastroenterol Nutr 9(3):314–321PubMed Omoike IU, Abiodun PO (1989) Upper small intestinal microflora in diarrhea and malnutrition in Nigerian children. J Pediatr Gastroenterol Nutr 9(3):314–321PubMed
18.
Zurück zum Zitat Chang CS, Chen GH, Kao CH, Wang SJ, Peng SN, Huang CK, Poon SK (1995) Increased accuracy of the carbon-14 d-xylose breath test in detecting small-intestinal bacterial overgrowth by correction with the gastric emptying rate. Eur J Nucl Med 22(10):1118–1122PubMedCrossRef Chang CS, Chen GH, Kao CH, Wang SJ, Peng SN, Huang CK, Poon SK (1995) Increased accuracy of the carbon-14 d-xylose breath test in detecting small-intestinal bacterial overgrowth by correction with the gastric emptying rate. Eur J Nucl Med 22(10):1118–1122PubMedCrossRef
19.
Zurück zum Zitat King CE, Toskes PP, Spivey JC, Lorenz E, Welkos S (1979) Detection of small intestine bacterial overgrowth by means of a 14C-d-xylose breath test. Gastroenterology 77(1):75–82PubMed King CE, Toskes PP, Spivey JC, Lorenz E, Welkos S (1979) Detection of small intestine bacterial overgrowth by means of a 14C-d-xylose breath test. Gastroenterology 77(1):75–82PubMed
20.
Zurück zum Zitat Lewis SJ, Young G, Mann M, Franco S, O’Keefe SJ (1997) Improvement in specificity of [14C]d-xylose breath test for bacterial overgrowth. Dig Dis Sci 42(8):1587–1592PubMedCrossRef Lewis SJ, Young G, Mann M, Franco S, O’Keefe SJ (1997) Improvement in specificity of [14C]d-xylose breath test for bacterial overgrowth. Dig Dis Sci 42(8):1587–1592PubMedCrossRef
21.
Zurück zum Zitat Rumessen JJ, Gudmand-Hoyer E, Bachmann E, Justesen T (1985) Diagnosis of bacterial overgrowth of the small intestine, comparison of the 14C-d-xylose breath test and jejunal cultures in 60 patients. Scand J Gastroenterol 20:1267–1275PubMedCrossRef Rumessen JJ, Gudmand-Hoyer E, Bachmann E, Justesen T (1985) Diagnosis of bacterial overgrowth of the small intestine, comparison of the 14C-d-xylose breath test and jejunal cultures in 60 patients. Scand J Gastroenterol 20:1267–1275PubMedCrossRef
22.
Zurück zum Zitat Skar V, Larsen S, Osnes M (1985) The 1-g 14C-d-xylose breath test in gallstone patients with and without duodenal diverticula. Scand J Gastroenterol 20(4):447–451PubMedCrossRef Skar V, Larsen S, Osnes M (1985) The 1-g 14C-d-xylose breath test in gallstone patients with and without duodenal diverticula. Scand J Gastroenterol 20(4):447–451PubMedCrossRef
23.
Zurück zum Zitat Valdovinos MA, Camilleri M, Thomforde GM, Frie C (1993) Reduced accuracy of 14C-d-xylose breath test for detecting bacterial overgrowth in gastrointestinal motility disorders. Scand J Gastroenterol 28(11):963–968PubMedCrossRef Valdovinos MA, Camilleri M, Thomforde GM, Frie C (1993) Reduced accuracy of 14C-d-xylose breath test for detecting bacterial overgrowth in gastrointestinal motility disorders. Scand J Gastroenterol 28(11):963–968PubMedCrossRef
24.
Zurück zum Zitat Bauer TM, Schwacha H, Steinbruckner B, Brinkmann FE, Ditzen AK, Kist M, Blum HE (2000) Diagnosis of small intestinal bacterial overgrowth in patients with cirrhosis of the liver: poor performance of the glucose breath hydrogen test. J Hepatol 33(3):382–386PubMedCrossRef Bauer TM, Schwacha H, Steinbruckner B, Brinkmann FE, Ditzen AK, Kist M, Blum HE (2000) Diagnosis of small intestinal bacterial overgrowth in patients with cirrhosis of the liver: poor performance of the glucose breath hydrogen test. J Hepatol 33(3):382–386PubMedCrossRef
25.
Zurück zum Zitat de Boissieu D, Chaussain M, Badoual J, Raymond J, Dupont C (1996) Small-bowel bacterial overgrowth in children with chronic diarrhea, abdominal pain, or both. J Pediatr 128(2):203–207PubMedCrossRef de Boissieu D, Chaussain M, Badoual J, Raymond J, Dupont C (1996) Small-bowel bacterial overgrowth in children with chronic diarrhea, abdominal pain, or both. J Pediatr 128(2):203–207PubMedCrossRef
26.
Zurück zum Zitat Lupascu A, Gabrielli M, Lauritano EC, Scarpellini E, Santoliquido A, Cammarota G, Flore R, Tondi P, Pola P, Gasbarrini G, Gasbarrini A (2005) Hydrogen glucose breath test to detect small intestinal bacterial overgrowth: a prevalence case–control study in irritable bowel syndrome. Aliment Pharmacol Ther 22(11–12):1157–1166PubMedCrossRef Lupascu A, Gabrielli M, Lauritano EC, Scarpellini E, Santoliquido A, Cammarota G, Flore R, Tondi P, Pola P, Gasbarrini G, Gasbarrini A (2005) Hydrogen glucose breath test to detect small intestinal bacterial overgrowth: a prevalence case–control study in irritable bowel syndrome. Aliment Pharmacol Ther 22(11–12):1157–1166PubMedCrossRef
27.
Zurück zum Zitat Pignata C, Budillon G, Monaco G, Nani E, Cuomo R, Parrilli G, Ciccimarra F (1990) Jejunal bacterial overgrowth and intestinal permeability in children with immunodeficiency syndromes. Gut 31(8):879–882PubMedCrossRef Pignata C, Budillon G, Monaco G, Nani E, Cuomo R, Parrilli G, Ciccimarra F (1990) Jejunal bacterial overgrowth and intestinal permeability in children with immunodeficiency syndromes. Gut 31(8):879–882PubMedCrossRef
28.
Zurück zum Zitat Trespi E, Ferrieri A (1999) Intestinal bacterial overgrowth during chronic pancreatitis. Curr Med Res Opin 15(1):47–52PubMed Trespi E, Ferrieri A (1999) Intestinal bacterial overgrowth during chronic pancreatitis. Curr Med Res Opin 15(1):47–52PubMed
29.
Zurück zum Zitat Yang CY, Chang CS, Chen GH (1998) Small-intestinal bacterial overgrowth in patients with liver cirrhosis, diagnosed with glucose H2 or CH4 breath tests. Scand J Gastroenterol 33(8):867–871PubMedCrossRef Yang CY, Chang CS, Chen GH (1998) Small-intestinal bacterial overgrowth in patients with liver cirrhosis, diagnosed with glucose H2 or CH4 breath tests. Scand J Gastroenterol 33(8):867–871PubMedCrossRef
30.
Zurück zum Zitat 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(1):79–82PubMedCrossRef 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(1):79–82PubMedCrossRef
31.
Zurück zum Zitat Casellas F, Chicharro L, Malagelada JR (1993) Potential usefulness of hydrogen breath test with d-xylose in clinical management of intestinal malabsorption. Dig Dis Sci 38(2):321–327PubMedCrossRef Casellas F, Chicharro L, Malagelada JR (1993) Potential usefulness of hydrogen breath test with d-xylose in clinical management of intestinal malabsorption. Dig Dis Sci 38(2):321–327PubMedCrossRef
32.
Zurück zum Zitat Riordan SM, McIver CJ, Duncombe VM, Bolin TD, Thomas MC (1995) Factors influencing the 1-g 14C-d-xylose breath test for bacterial overgrowth. Am J Gastroenterol 90(9):1455–1460PubMed Riordan SM, McIver CJ, Duncombe VM, Bolin TD, Thomas MC (1995) Factors influencing the 1-g 14C-d-xylose breath test for bacterial overgrowth. Am J Gastroenterol 90(9):1455–1460PubMed
33.
Zurück zum Zitat Farivar S, Fromm H, Schindler D, Schmidt FW (1979) Sensitivity of bile acid breath test in the diagnosis of bacterial overgrowth in the small intestine with and without the stagnant (blind) loop syndrome. Dig Dis Sci 24(1):33–40PubMedCrossRef Farivar S, Fromm H, Schindler D, Schmidt FW (1979) Sensitivity of bile acid breath test in the diagnosis of bacterial overgrowth in the small intestine with and without the stagnant (blind) loop syndrome. Dig Dis Sci 24(1):33–40PubMedCrossRef
34.
Zurück zum Zitat Hellemans J, Joosten E, Ghoos Y, Carchon H, Vantrappen G, Pelemans W, Rutgeerts P (1984) Positive 14CO2 bile acid breath test in elderly people. Age Ageing 13(3):138–143PubMedCrossRef Hellemans J, Joosten E, Ghoos Y, Carchon H, Vantrappen G, Pelemans W, Rutgeerts P (1984) Positive 14CO2 bile acid breath test in elderly people. Age Ageing 13(3):138–143PubMedCrossRef
35.
Zurück zum Zitat Kocoshis SA, Schletewitz K, Lovelace G, Laine RA (1987) Duodenal bile acids among children: keto derivatives and aerobic small bowel bacterial overgrowth. J Pediatr Gastroenterol Nutr 6(5):686–696PubMedCrossRef Kocoshis SA, Schletewitz K, Lovelace G, Laine RA (1987) Duodenal bile acids among children: keto derivatives and aerobic small bowel bacterial overgrowth. J Pediatr Gastroenterol Nutr 6(5):686–696PubMedCrossRef
36.
Zurück zum Zitat Lauterburg BH, Newcomer AD, Hofmann AF (1978) Clinical value of the bile acid breath test. Evaluation of the Mayo clinic experience. Mayo Clin Proc 53(4):227–233PubMed Lauterburg BH, Newcomer AD, Hofmann AF (1978) Clinical value of the bile acid breath test. Evaluation of the Mayo clinic experience. Mayo Clin Proc 53(4):227–233PubMed
37.
Zurück zum Zitat Roda A, Roda E, Aldini R, Mazzella G, Festi D, Sama C, Barbara L (1977) Determination of 14CO2 in breath and 14C in stool after oral administration of cholyl-1-[14C]glycine: clinical application. Clin Chem 23(11):2127–2132PubMed Roda A, Roda E, Aldini R, Mazzella G, Festi D, Sama C, Barbara L (1977) Determination of 14CO2 in breath and 14C in stool after oral administration of cholyl-1-[14C]glycine: clinical application. Clin Chem 23(11):2127–2132PubMed
38.
Zurück zum Zitat Shindo K, Machida M, Miyakawa K, Fukumura M (1993) A syndrome of cirrhosis, achlorhydria, small intestinal bacterial overgrowth, and fat malabsorption. Am J Gastroenterol 88(12):2084–2091PubMed Shindo K, Machida M, Miyakawa K, Fukumura M (1993) A syndrome of cirrhosis, achlorhydria, small intestinal bacterial overgrowth, and fat malabsorption. Am J Gastroenterol 88(12):2084–2091PubMed
39.
Zurück zum Zitat Parkin DM, O’Moore RR, Cussons DJ, Warwick RR, Rooney P, Percy-Robb IW, Shearman DJ (1972) Evaluation of the “breath test” in the detection of bacterial colonisation of the upper gastrointestinal tract. Lancet 2(7781):777–780PubMedCrossRef Parkin DM, O’Moore RR, Cussons DJ, Warwick RR, Rooney P, Percy-Robb IW, Shearman DJ (1972) Evaluation of the “breath test” in the detection of bacterial colonisation of the upper gastrointestinal tract. Lancet 2(7781):777–780PubMedCrossRef
40.
Zurück zum Zitat Hamilton JD, Dyer NH, Dawson AM, O’Grady FW, Vince A, Fenton JC, Mollin DL (1970) Assessment and significance of bacterial overgrowth in the small bowel. Q J Med 39(154):265–285PubMed Hamilton JD, Dyer NH, Dawson AM, O’Grady FW, Vince A, Fenton JC, Mollin DL (1970) Assessment and significance of bacterial overgrowth in the small bowel. Q J Med 39(154):265–285PubMed
41.
Zurück zum Zitat Patney NL, Saxena SK, Mehrotra MP, Khanna HK, Lahiri VL, Kumar A (1979) A correlative study of indicanuria and jejunal bacteriology in diabetes mellitus. Indian J Med Sci 33(5):115–120PubMed Patney NL, Saxena SK, Mehrotra MP, Khanna HK, Lahiri VL, Kumar A (1979) A correlative study of indicanuria and jejunal bacteriology in diabetes mellitus. Indian J Med Sci 33(5):115–120PubMed
42.
Zurück zum Zitat Patney NL, Mehrotra MP, Khanna HK, Goyal SP, Kumar A (1979) Urinary indican as a screening index of jejunal bacterial flora in Indian adulthood cirrhosis. Indian J Med Sci 33(6):150–156PubMed Patney NL, Mehrotra MP, Khanna HK, Goyal SP, Kumar A (1979) Urinary indican as a screening index of jejunal bacterial flora in Indian adulthood cirrhosis. Indian J Med Sci 33(6):150–156PubMed
43.
Zurück zum Zitat Bardhan PK, Feger A, Kogon M, Muller J, Gillessen D, Beglinger C, Gyr N (2000) Urinary choloyl-PABA excretion in diagnosing small intestinal bacterial overgrowth: evaluation of a new noninvasive method. Dig Dis Sci 45(3):474–479PubMedCrossRef Bardhan PK, Feger A, Kogon M, Muller J, Gillessen D, Beglinger C, Gyr N (2000) Urinary choloyl-PABA excretion in diagnosing small intestinal bacterial overgrowth: evaluation of a new noninvasive method. Dig Dis Sci 45(3):474–479PubMedCrossRef
44.
Zurück zum Zitat Chalmers RA, Valman HB, Liberman MM (1979) Measurement of 4-hydroxyphenylacetic aciduria as a screening test for small-bowel disease. Clin Chem 25(10):1791–1794PubMed Chalmers RA, Valman HB, Liberman MM (1979) Measurement of 4-hydroxyphenylacetic aciduria as a screening test for small-bowel disease. Clin Chem 25(10):1791–1794PubMed
45.
Zurück zum Zitat Corazza GR, Strocchi A, Gasbarrini G (1987) Fasting breath hydrogen in celiac disease. Gastroenterology 93(1):53–58PubMed Corazza GR, Strocchi A, Gasbarrini G (1987) Fasting breath hydrogen in celiac disease. Gastroenterology 93(1):53–58PubMed
46.
Zurück zum Zitat Riordan SM, McIver CJ, Bolin TD, Duncombe VM (1995) Fasting breath hydrogen concentrations in gastric and small-intestinal bacterial overgrowth. Scand J Gastroenterol 30(3):252–257PubMedCrossRef Riordan SM, McIver CJ, Bolin TD, Duncombe VM (1995) Fasting breath hydrogen concentrations in gastric and small-intestinal bacterial overgrowth. Scand J Gastroenterol 30(3):252–257PubMedCrossRef
47.
Zurück zum Zitat Hauge T, Persson J, Danielsson D (1997) Mucosal bacterial growth in the upper gastrointestinal tract in alcoholics (heavy drinkers). Digestion 58(6):591–595PubMed Hauge T, Persson J, Danielsson D (1997) Mucosal bacterial growth in the upper gastrointestinal tract in alcoholics (heavy drinkers). Digestion 58(6):591–595PubMed
48.
Zurück zum Zitat Donald IP, Kitchingmam G, Donald F, Kupfer RM (1992) The diagnosis of small bowel bacterial overgrowth in elderly patients. J Am Geriatr Soc 40(7):692–696PubMed Donald IP, Kitchingmam G, Donald F, Kupfer RM (1992) The diagnosis of small bowel bacterial overgrowth in elderly patients. J Am Geriatr Soc 40(7):692–696PubMed
49.
Zurück zum Zitat Kerlin P, Wong L (1988) Breath hydrogen testing in bacterial overgrowth of the small intestine. Gastroenterology 95(4):982–988PubMed Kerlin P, Wong L (1988) Breath hydrogen testing in bacterial overgrowth of the small intestine. Gastroenterology 95(4):982–988PubMed
50.
Zurück zum Zitat King CE, Toskes PP, Guilarte TR, Lorenz E, Welkos SL (1980) Comparison of the one-gram d-[14C]xylose breath test to the [14C]bile acid breath test in patients with small-intestine bacterial overgrowth. Dig Dis Sci 25(1):53–58PubMedCrossRef King CE, Toskes PP, Guilarte TR, Lorenz E, Welkos SL (1980) Comparison of the one-gram d-[14C]xylose breath test to the [14C]bile acid breath test in patients with small-intestine bacterial overgrowth. Dig Dis Sci 25(1):53–58PubMedCrossRef
51.
Zurück zum Zitat King CE, Toskes PP (1986) Comparison of the 1-gram [14C]xylose, 10-gram lactulose-H2, and 80-gram glucose-H2 breath tests in patients with small intestine bacterial overgrowth. Gastroenterology 91(6):1447–1451PubMed King CE, Toskes PP (1986) Comparison of the 1-gram [14C]xylose, 10-gram lactulose-H2, and 80-gram glucose-H2 breath tests in patients with small intestine bacterial overgrowth. Gastroenterology 91(6):1447–1451PubMed
52.
Zurück zum Zitat Posserud I, Stotzer PO, Bjornsson ES, Abrahamsson H, Simren M (2007) Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut 56(6):802–808PubMedCrossRef Posserud I, Stotzer PO, Bjornsson ES, Abrahamsson H, Simren M (2007) Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut 56(6):802–808PubMedCrossRef
53.
Zurück zum Zitat Rhodes JM, Middleton P, Jewell DP (1979) The lactulose hydrogen breath test as a diagnostic test for small-bowel bacterial overgrowth. Scand J Gastroenterol 14(3):333–336PubMed Rhodes JM, Middleton P, Jewell DP (1979) The lactulose hydrogen breath test as a diagnostic test for small-bowel bacterial overgrowth. Scand J Gastroenterol 14(3):333–336PubMed
54.
Zurück zum Zitat Schneider A, Novis B, Chen V, Leichtman G (1985) Value of the 14C-d-xylose breath test in patients with intestinal bacterial overgrowth. Digestion 32(2):86–91PubMed Schneider A, Novis B, Chen V, Leichtman G (1985) Value of the 14C-d-xylose breath test in patients with intestinal bacterial overgrowth. Digestion 32(2):86–91PubMed
55.
Zurück zum Zitat Stotzer PO, Kilander AF (2000) Comparison of the 1-gram (14)C-d-xylose breath test and the 50-gram hydrogen glucose breath test for diagnosis of small intestinal bacterial overgrowth. Digestion 61(3):165–171PubMedCrossRef Stotzer PO, Kilander AF (2000) Comparison of the 1-gram (14)C-d-xylose breath test and the 50-gram hydrogen glucose breath test for diagnosis of small intestinal bacterial overgrowth. Digestion 61(3):165–171PubMedCrossRef
56.
Zurück zum Zitat Teo M, Chung S, Chitti L, Tran C, Kritas S, Butler R, Cummins A (2004) Small bowel bacterial overgrowth is a common cause of chronic diarrhea. J Gastroenterol Hepatol 19(8):904–909PubMedCrossRef Teo M, Chung S, Chitti L, Tran C, Kritas S, Butler R, Cummins A (2004) Small bowel bacterial overgrowth is a common cause of chronic diarrhea. J Gastroenterol Hepatol 19(8):904–909PubMedCrossRef
57.
Zurück zum Zitat Walters B, Vanner SJ (2005) Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-d-xylose and healthy controls. Am J Gastroenterol 100(7):1566–1570PubMedCrossRef Walters B, Vanner SJ (2005) Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-d-xylose and healthy controls. Am J Gastroenterol 100(7):1566–1570PubMedCrossRef
58.
Zurück zum Zitat Northfield TC, Drasar BS, Wright JT (1973) Value of small intestinal bile acid analysis in the diagnosis of the stagnant loop syndrome. Gut 14(5):341–347PubMedCrossRef Northfield TC, Drasar BS, Wright JT (1973) Value of small intestinal bile acid analysis in the diagnosis of the stagnant loop syndrome. Gut 14(5):341–347PubMedCrossRef
59.
Zurück zum Zitat Corazza GR, Menozzi MG, Strocchi A, Rasciti L, Vaira D, Lecchini R, Avanzini P, Chezzi C, Gasbarrini G (1990) The diagnosis of small bowel bacterial overgrowth. Reliability of jejunal culture and inadequacy of breath hydrogen testing. Gastroenterology 98(2):302–309PubMed Corazza GR, Menozzi MG, Strocchi A, Rasciti L, Vaira D, Lecchini R, Avanzini P, Chezzi C, Gasbarrini G (1990) The diagnosis of small bowel bacterial overgrowth. Reliability of jejunal culture and inadequacy of breath hydrogen testing. Gastroenterology 98(2):302–309PubMed
60.
Zurück zum Zitat Ghoshal UC, Ghoshal U, Das K, Misra A (2006) Utility of hydrogen breath tests in diagnosis of small intestinal bacterial overgrowth in malabsorption syndrome and its relationship with oro-cecal transit time. Indian J Gastroenterol 25(1):6–10PubMed Ghoshal UC, Ghoshal U, Das K, Misra A (2006) Utility of hydrogen breath tests in diagnosis of small intestinal bacterial overgrowth in malabsorption syndrome and its relationship with oro-cecal transit time. Indian J Gastroenterol 25(1):6–10PubMed
61.
Zurück zum Zitat Mac Mahon M, Gibbons N, Mullins E, O’Moore RR, Keane CT, Walsh JB, Coakley D (1996) Are hydrogen breath tests valid in the elderly? Gerontology 42(1):40–45PubMedCrossRef Mac Mahon M, Gibbons N, Mullins E, O’Moore RR, Keane CT, Walsh JB, Coakley D (1996) Are hydrogen breath tests valid in the elderly? Gerontology 42(1):40–45PubMedCrossRef
62.
Zurück zum Zitat Riordan SM, McIver CJ, Duncombe VM, Bolin TD (1995) An appraisal of a ‘string test’ for the detection of small bowel bacterial overgrowth. J Trop Med Hyg 98(2):117–120PubMed Riordan SM, McIver CJ, Duncombe VM, Bolin TD (1995) An appraisal of a ‘string test’ for the detection of small bowel bacterial overgrowth. J Trop Med Hyg 98(2):117–120PubMed
63.
Zurück zum Zitat Riordan SM, McIver CJ, Walker BM, Duncombe VM, Bolin TD, Thomas MC (1996) The lactulose breath hydrogen test and small intestinal bacterial overgrowth. Am J Gastroenterol 91(9):1795–1803PubMed Riordan SM, McIver CJ, Walker BM, Duncombe VM, Bolin TD, Thomas MC (1996) The lactulose breath hydrogen test and small intestinal bacterial overgrowth. Am J Gastroenterol 91(9):1795–1803PubMed
64.
Zurück zum Zitat Riordan SM, McIver CJ, Duncombe VM, Thomas MC, Bolin TD (2000) Evaluation of the rice breath hydrogen test for small intestinal bacterial overgrowth. Am J Gastroenterol 95(10):2858–2864PubMedCrossRef Riordan SM, McIver CJ, Duncombe VM, Thomas MC, Bolin TD (2000) Evaluation of the rice breath hydrogen test for small intestinal bacterial overgrowth. Am J Gastroenterol 95(10):2858–2864PubMedCrossRef
65.
Zurück zum Zitat Einarsson K, Bergstrom M, Eklof R, Nord CE, Bjorkhem I (1992) Comparison of the proportion of unconjugated to total serum cholic acid and the [14C]-xylose breath test in patients with suspected small intestinal bacterial overgrowth. Scand J Clin Lab Invest 52(5):425–430PubMedCrossRef Einarsson K, Bergstrom M, Eklof R, Nord CE, Bjorkhem I (1992) Comparison of the proportion of unconjugated to total serum cholic acid and the [14C]-xylose breath test in patients with suspected small intestinal bacterial overgrowth. Scand J Clin Lab Invest 52(5):425–430PubMedCrossRef
66.
Zurück zum Zitat Kaye SA, Lim SG, Taylor M, Patel S, Gillespie S, Black CM (1995) Small bowel bacterial overgrowth in systemic sclerosis: detection using direct and indirect methods and treatment outcome. Br J Rheumatol 34(3):265–269PubMedCrossRef Kaye SA, Lim SG, Taylor M, Patel S, Gillespie S, Black CM (1995) Small bowel bacterial overgrowth in systemic sclerosis: detection using direct and indirect methods and treatment outcome. Br J Rheumatol 34(3):265–269PubMedCrossRef
67.
Zurück zum Zitat Khin-Maung-U, Tin-Aye, Ku-Tin-Myint, Tin-Oo, Myo-Khin, Thackway SA, Connor SJ, Bolin TD, Duncombe VM (1992) In vitro hydrogen production by enteric bacteria cultured from children with small bowel bacterial overgrowth. J Pediatr Gastroenterol Nutr 14(2):192–197 Khin-Maung-U, Tin-Aye, Ku-Tin-Myint, Tin-Oo, Myo-Khin, Thackway SA, Connor SJ, Bolin TD, Duncombe VM (1992) In vitro hydrogen production by enteric bacteria cultured from children with small bowel bacterial overgrowth. J Pediatr Gastroenterol Nutr 14(2):192–197
68.
Zurück zum Zitat Saltzman JR, Kowdley KV, Pedrosa MC, Sepe T, Golner B, Perrone G, Russell RM (1994) Bacterial overgrowth without clinical malabsorption in elderly hypochlorhydric subjects. Gastroenterology 106(3):615–623PubMed Saltzman JR, Kowdley KV, Pedrosa MC, Sepe T, Golner B, Perrone G, Russell RM (1994) Bacterial overgrowth without clinical malabsorption in elderly hypochlorhydric subjects. Gastroenterology 106(3):615–623PubMed
69.
Zurück zum Zitat Leon-Barua R, Gilman RH, Rodriguez C, Bonilla JJ, Yi A, Maurtua D, Sack RB (1993) Comparison of three methods to obtain upper small bowel contents for culture. Am J Gastroenterol 88(6):925–928PubMed Leon-Barua R, Gilman RH, Rodriguez C, Bonilla JJ, Yi A, Maurtua D, Sack RB (1993) Comparison of three methods to obtain upper small bowel contents for culture. Am J Gastroenterol 88(6):925–928PubMed
70.
Zurück zum Zitat Bjorneklett A, Fausa O, Midtvedt T (1983) Small-bowel bacterial overgrowth in the postgastrectomy syndrome. Scand J Gastroenterol 18(2):277–287PubMedCrossRef Bjorneklett A, Fausa O, Midtvedt T (1983) Small-bowel bacterial overgrowth in the postgastrectomy syndrome. Scand J Gastroenterol 18(2):277–287PubMedCrossRef
71.
Zurück zum Zitat Corazza GR, Ventrucci M, Strocchi A, Sorge M, Pranzo L, Pezzilli R, Gasbarrini G (1988) Treatment of small intestine bacterial overgrowth with rifaximin, a non-absorbable rifamycin. J Int Med Res 16(4):312–316PubMed Corazza GR, Ventrucci M, Strocchi A, Sorge M, Pranzo L, Pezzilli R, Gasbarrini G (1988) Treatment of small intestine bacterial overgrowth with rifaximin, a non-absorbable rifamycin. J Int Med Res 16(4):312–316PubMed
72.
Zurück zum Zitat Haboubi NY, Cowley PA, Lee GS (1988) Small bowel bacterial overgrowth: a cause of malnutrition in the elderly? Eur J Clin Nutr 42(12):999–1005PubMed Haboubi NY, Cowley PA, Lee GS (1988) Small bowel bacterial overgrowth: a cause of malnutrition in the elderly? Eur J Clin Nutr 42(12):999–1005PubMed
73.
Zurück zum Zitat Pimentel M, Chow EJ, Lin HC (2000) Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol 95(12):3503–3506PubMedCrossRef Pimentel M, Chow EJ, Lin HC (2000) Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol 95(12):3503–3506PubMedCrossRef
74.
Zurück zum Zitat Madrid AM, Hurtado C, Venegas M, Cumsille F, Defilippi C (2001) Long-term treatment with cisapride and antibiotics in liver cirrhosis: effect on small intestinal motility, bacterial overgrowth, and liver function. Am J Gastroenterol 96(4):1251–1255PubMedCrossRef Madrid AM, Hurtado C, Venegas M, Cumsille F, Defilippi C (2001) Long-term treatment with cisapride and antibiotics in liver cirrhosis: effect on small intestinal motility, bacterial overgrowth, and liver function. Am J Gastroenterol 96(4):1251–1255PubMedCrossRef
75.
Zurück zum Zitat Di Stefano M, Malservisi S, Veneto G, Ferrieri A, Corazza GR (2000) Rifaximin versus chlortetracycline in the short-term treatment of small intestinal bacterial overgrowth. Aliment Pharmacol Ther 14(5):551–556PubMedCrossRef Di Stefano M, Malservisi S, Veneto G, Ferrieri A, Corazza GR (2000) Rifaximin versus chlortetracycline in the short-term treatment of small intestinal bacterial overgrowth. Aliment Pharmacol Ther 14(5):551–556PubMedCrossRef
76.
Zurück zum Zitat Cuoco L, Salvagnini M (2006) Small intestine bacterial overgrowth in irritable bowel syndrome: a retrospective study with rifaximin. Minerva Gastroenterol Dietol 52(1):89–95PubMed Cuoco L, Salvagnini M (2006) Small intestine bacterial overgrowth in irritable bowel syndrome: a retrospective study with rifaximin. Minerva Gastroenterol Dietol 52(1):89–95PubMed
77.
Zurück zum Zitat Farivar S, Fromm H, Schindler D, Schmidt FW (1979) Sensitivity of bile acid breath test in the diagnosis of bacterial overgrowth in the small intestine with and without the stagnant (blind) loop syndrome. Dig Dis Sci 24(1):33–40PubMedCrossRef Farivar S, Fromm H, Schindler D, Schmidt FW (1979) Sensitivity of bile acid breath test in the diagnosis of bacterial overgrowth in the small intestine with and without the stagnant (blind) loop syndrome. Dig Dis Sci 24(1):33–40PubMedCrossRef
78.
Zurück zum Zitat Van Outryve M, Huybrechts W, Blaauw AM, De Weerdt GA, Beke R, Barbier F (1978) Jejunal bile salts and microflora in patients with partial gastrectomy. Am J Gastroenterol 69(5):550–558PubMed Van Outryve M, Huybrechts W, Blaauw AM, De Weerdt GA, Beke R, Barbier F (1978) Jejunal bile salts and microflora in patients with partial gastrectomy. Am J Gastroenterol 69(5):550–558PubMed
79.
Zurück zum Zitat Riordan SM, McIver CJ, Thomas DH, Duncombe VM, Bolin TD, Thomas MC (1997) Luminal bacteria and small-intestinal permeability. Scand J Gastroenterol 32(6):556–563PubMedCrossRef Riordan SM, McIver CJ, Thomas DH, Duncombe VM, Bolin TD, Thomas MC (1997) Luminal bacteria and small-intestinal permeability. Scand J Gastroenterol 32(6):556–563PubMedCrossRef
80.
Zurück zum Zitat Egger G, Kessler JI (1973) Clinical experience with a simple test for the detection of bacterial deconjugation of bile salts and the site and extent of bacterial overgrowth in the small intestine. Gastroenterology 64(4):545–551PubMed Egger G, Kessler JI (1973) Clinical experience with a simple test for the detection of bacterial deconjugation of bile salts and the site and extent of bacterial overgrowth in the small intestine. Gastroenterology 64(4):545–551PubMed
81.
Zurück zum Zitat Tabaqchali S, Okubadejo OA, Neale G, Booth CC (1966) Influence of abnormal bacterial flora on small intestinal function. Proc R Soc Med 59(12):1244–1246PubMed Tabaqchali S, Okubadejo OA, Neale G, Booth CC (1966) Influence of abnormal bacterial flora on small intestinal function. Proc R Soc Med 59(12):1244–1246PubMed
82.
Zurück zum Zitat Mayer PJ, Beeken WL (1975) The role of urinary indican as a predictor of bacterial colonization in the human jejunum. Am J Dig Dis 20(11):1003–1009PubMedCrossRef Mayer PJ, Beeken WL (1975) The role of urinary indican as a predictor of bacterial colonization in the human jejunum. Am J Dig Dis 20(11):1003–1009PubMedCrossRef
83.
Zurück zum Zitat Attar A, Flourie B, Rambaud JC, Franchisseur C, Ruszniewski P, Bouhnik Y (1999) Antibiotic efficacy in small intestinal bacterial overgrowth-related chronic diarrhea: a crossover, randomized trial. Gastroenterology 117(4):794–797PubMedCrossRef Attar A, Flourie B, Rambaud JC, Franchisseur C, Ruszniewski P, Bouhnik Y (1999) Antibiotic efficacy in small intestinal bacterial overgrowth-related chronic diarrhea: a crossover, randomized trial. Gastroenterology 117(4):794–797PubMedCrossRef
84.
Zurück zum Zitat Gorbach SL, Plaut AG, Nahas L, Weinstein L, Spanknebel G, Levitan R (1967) Studies of intestinal microflora. II. Microorganisms of the small intestine and their relations to oral and fecal flora. Gastroenterology 53(6):856–867PubMed Gorbach SL, Plaut AG, Nahas L, Weinstein L, Spanknebel G, Levitan R (1967) Studies of intestinal microflora. II. Microorganisms of the small intestine and their relations to oral and fecal flora. Gastroenterology 53(6):856–867PubMed
85.
Zurück zum Zitat Tillman RKC, Toskes P (1981) Continued experience with the xylose breath test: evidence that the small bowel culture as the gold standard for bacterial overgrowth may be tarnished. Gastroenterology 80:A1304 Tillman RKC, Toskes P (1981) Continued experience with the xylose breath test: evidence that the small bowel culture as the gold standard for bacterial overgrowth may be tarnished. Gastroenterology 80:A1304
86.
Zurück zum Zitat Romagnuolo J, Schiller D, Bailey RJ (2002) Using breath tests wisely in a gastroenterology practice: an evidence-based review of indications and pitfalls in interpretation. Am J Gastroenterol 97(5):1113–1126PubMedCrossRef Romagnuolo J, Schiller D, Bailey RJ (2002) Using breath tests wisely in a gastroenterology practice: an evidence-based review of indications and pitfalls in interpretation. Am J Gastroenterol 97(5):1113–1126PubMedCrossRef
87.
Zurück zum Zitat Rosenberg IH, Hardison WG, Bull DM (1967) Abnormal bile-salt patterns and intestinal bacterial overgrowth associated with malabsorption. N Engl J Med 276(25):1391–1397PubMedCrossRef Rosenberg IH, Hardison WG, Bull DM (1967) Abnormal bile-salt patterns and intestinal bacterial overgrowth associated with malabsorption. N Engl J Med 276(25):1391–1397PubMedCrossRef
Metadaten
Titel
A Systematic Review of Diagnostic Tests for Small Intestinal Bacterial Overgrowth
verfasst von
Reza Khoshini
Sun-Chuan Dai
Sheila Lezcano
Mark Pimentel
Publikationsdatum
01.06.2008
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 6/2008
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-007-0065-1

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