The small intestinal bacterial overgrowth syndrome in patients with gastroesophageal reflux disease, irritable bowel syndrome and its combination

The prevalence of the small intestine bacterial overgrowth syndrome (SIBOS) in patients with gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS) and its combination and its comparison with the control group of practically healthy people were investigated. To diagnose SIBOS in patients with GERD, IBS and its combination, we used hydrogen breath tests with different substrates and seeding of small intestinal contents obtained during endoscopy. According to the results of small intestinal culture in patients with isolated IBS and combination of GERD with IBS, significantly more than in healthy people, SIBOS occurs. With isolated GERD, no such difference was found. When sowing intestinal contents, Escherichia coli, Enterococcus, Proteus, Klebsiella were detected more often, in 19% of cases several microorganisms were sown. SIBOS was more often detected in patients with IBS with diarrhea and mixed IBS than with IBS with constipation and un-subtyped IBS. Reception of proton pump inhibitors does not significantly affect the frequency of detection of SIBOS. Hydrogen breath tests with glucose and lactulose are highly informative in the diagnosis of SIBR and give results close to the results of inoculation. Hydrogen tests with sorbitol and fructose have insufficient sensitivity in the diagnosis of SIBR and can be used to detect intolerance of these substrates with the development of secondary SIBR.