Small Bowel Bacterial Overgrowth in Patients with Irritable Bowel Syndrome: The First Study in Iran

BACKGROUND Small intestinal bacterial overgrowth (SIBO) may have a role in the pathophysiology of irritable bowel syndrome (IBS). So, the aim of this study was to assess the association between SIBO and IBS by using glucose breath test (GBT) in Kerman city as the first study in Iranian population. METHODS 107 patients with IBS and 107 healthy individuals were enrolled in our study. All the participants underwent GBT. A peak of H2 values >20 p.p.m above the basal value after glucose ingestion was considered suggestive of SIBO. SPSS software version 17 was used for data analysis. P value < 0.05 was considered as statistically significant. RESULTS Of the 107 patients with IBS, 40 had positive GBT (37.4%) compared with 14 (12.1%) out of the 107 control participants(p< 0.001). Dominant symptoms in patients with IBS were diarrhea in 36(33.6%), constipation in 12(11.2%), abdominal pain in 22(20.6%), bloating in 28(26.2%), and change in bowel habit in 9(8.4%) patients. There was not statistically significant difference among any of this IBS subgroups and positive GBT (p=0.44). CONCLUSION There is a positive association between IBS and SIBO. We suggest a Placebo-controlled bacterial eradication study for identifying the role of SIBO in IBS.