Small intestinal bacterial overgrowth

From IDWiki

Clinical Manifestations

  • Bloating, abdominal pain, gas
  • Rarely, steatorrhea
  • Traditionally a complication of GI surgery (particularly bypass surgery), though some hypothesize can contribute to dyspepsia, IBS, and other chronic issues

Diagnosis

  • Carbohydrate breath tests that check for hydrogen and methane gases which are produced by the bacterial fermentation of sugars like lactulose or glucose
    • Need to avoid antibiotics 4 weeks prior to testing, laxatives 1 week prior, and complex carbs in food for 12 hours prior
    • Detects an increase in expired hydrogen of 20 ppm or more within 90 minutes of administration of the sugar, or increase in methane level