{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:24:50Z","timestamp":1783013090726,"version":"3.54.6"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Aims<\/jats:title>\n                    <jats:p>Hydrogen breath testing is a widely used, noninvasive method for diagnosing small intestinal bacterial overgrowth. However, diagnostic cut\u2010offs vary across international guidelines. This study evaluated the diagnostic performance of differing criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively studied consecutive adults with irritable bowel syndrome who underwent glucose hydrogen breath testing. Small intestinal bacterial overgrowth was diagnosed using the Asia\u2010Pacific consensus (rise in hydrogen \u2265\u200912\u2009ppm from baseline) and the North American consensus (rise \u2265\u200920\u2009ppm). Methane \u2265\u200910\u2009ppm was considered methane\u2010positive in both.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety subjects were included (median age 49\u2009years; 53% female); 60% had diarrhea\u2010predominant subtype. Small intestinal bacterial overgrowth was diagnosed in 44.4% using Asia\u2010Pacific criteria and 37.8% using North American criteria. Hydrogen\u2010positive cases were significantly associated with diarrhea\u2010predominant subtype, while methane\u2010positive cases correlated with constipation\u2010predominant subtype. Severe irritable bowel syndrome symptoms (Symptom Severity Scale &gt;\u2009300) were more common in affected patients based on both Asia\u2010Pacific (32.5% vs. 8.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and North American (29.4% vs. 12.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047) criteria. Only the Asia\u2010Pacific criteria were significantly associated with higher symptom severity scores (median: 200 vs. 165,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), whereas this was not significant with the North American criteria (median: 200 vs. 170,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.087). Small intestinal bowel overgrowth was also linked to poorer quality of life and higher depression rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Asia\u2010Pacific consensus diagnostic criteria improved detection and identified cases associated with more severe irritable bowel syndrome. These findings support using a lower hydrogen cut\u2010off for breath testing, particularly in Asian populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70477","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:40:39Z","timestamp":1780533639000},"page":"2082-2088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Reassessing Small Intestinal Bacterial Overgrowth in Irritable Bowel Syndrome: A Comparative Study of Diagnostic Guidelines and Their Clinical Relevance"],"prefix":"10.1111","volume":"41","author":[{"given":"Audrey\u00a0Joe\u00a0Chii","family":"Loh","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine Universiti Malaya  Kuala Lumpur 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Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kewin\u00a0Tien\u2010Ho","family":"Siah","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Department of Medicine National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazreen","family":"Abdul\u00a0Majid","sequence":"additional","affiliation":[{"name":"Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine Universiti Malaya  Kuala Lumpur Malaysia"},{"name":"School of Health Rehabilitation Sciences Health Sciences University, Parkwood Campus  Bournemouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5824-0590","authenticated-orcid":false,"given":"Sanjiv","family":"Mahadeva","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine Universiti Malaya  Kuala 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