Small Intestinal Bacterial Overgrowth Syndrome Prevalence in Romanian Patients with Inflammatory Bowel Disease

ABSTRACT: Background: small intestinal bacterial overgrowth (SIBO) is an entity commonly associated with digestive disease. Recently, its association with inflammatory bowel diseases (IBD) made the object of an increasing number of investigations. Sometimes symptoms of excessive bacterial populations may overlap or mimic flares of inflammatory disease. Method: patients with IBD (CD – Crohn disease and UC – ulcerative colitis) in remission underwent screening for the presence of SIBO using the hydrogen breath test. Results: of the 75 patients tested, the breath test was positive for SIBO in 25.3% (30.77% of patients with CD and 19.4% of patients with UC). The risk factors associated with the presence of this syndrome were identified as: pancolonic impairment in UC, perianal and ileo-colonic involvement in CD, postoperative absence of the ileocecal valve. Patients in remission with bacterial overgrowth tend to present more frequently: a higher daily average of stools, a lower BMI (body mass index) and much more frequent complaints of persistent flatulence. Conclusions: patients with Crohn's disease suffer from small intestinal bacterial overgrowth syndrome more frequently than those with ulcerative colitis. The hydrogen breath test may be used, along with other laboratory methods, to distinguish between an inflammatory bowel disease and an overlap of small intestinal bacterial overgrowth.