{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:20:54Z","timestamp":1790806854775,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,3,18]],"date-time":"2014-03-18T00:00:00Z","timestamp":1395100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2014,6]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Small intestinal bacterial overgrowth (\n SIBO<\/jats:styled-content>\n ) may be a cause of irritable bowel syndrome (\n IBS<\/jats:styled-content>\n ); however, current investigations have important limitations. We aimed to identify clinically relevant diagnostic criteria for\n SIBO<\/jats:styled-content>\n based on lactulose hydrogen breath test (\n LHBT<\/jats:styled-content>\n ) alone and combined with scintigraphic measurement of oro\u2010cecal transit (\n SOCT<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Results of\n LHBT<\/jats:styled-content>\n \/\n SOCT<\/jats:styled-content>\n investigation from 89\n IBS<\/jats:styled-content>\n patients and 13 healthy volunteers were included in a systematic analysis of six published criteria for\n SIBO<\/jats:styled-content>\n diagnosis. Clinical relevance of competing criteria was determined by assessing (i) prevalence of\n SIBO<\/jats:styled-content>\n in\n IBS<\/jats:styled-content>\n patients and healthy volunteers (ii) if\n SIBO<\/jats:styled-content>\n diagnosis predicted improvement in\n IBS<\/jats:styled-content>\n symptoms in a prospective, pilot therapeutic trial of a non\u2010absorbable antibiotic (rifaximin 600\u00a0mg b.d.) in\n IBS<\/jats:styled-content>\n patients.\n <\/jats:p>\n <\/jats:sec>\n \n Key Results<\/jats:title>\n \n Reproducibility of\n SIBO<\/jats:styled-content>\n diagnosis by combined\n LHBT<\/jats:styled-content>\n \/\n SOCT<\/jats:styled-content>\n was near perfect. A \u22655\u00a0ppm H2 increase prior to appearance of cecal contrast was detected in more\n IBS<\/jats:styled-content>\n patients than healthy volunteers (35\/89\n vs<\/jats:italic>\n 1\/13;\n p<\/jats:italic>\n \u00a0=\u00a00.026), but not for other diagnostic criteria.\n IBS<\/jats:styled-content>\n patients with\n SIBO<\/jats:styled-content>\n , compared to those without\n SIBO<\/jats:styled-content>\n , reported significantly greater improvement in abdominal symptoms following rifaximin therapy (\n p<\/jats:italic>\n \u00a0<\u00a00.002 overall\n IBS<\/jats:styled-content>\n symptom severity). This improvement was most marked in D\u2010\n IBS<\/jats:styled-content>\n patients in whom all symptoms improved, including stool frequency and consistency (all\n p<\/jats:italic>\n \u00a0<\u00a00.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions & Inferences<\/jats:title>\n \n Combined\n LHBT<\/jats:styled-content>\n \/\n SOCT<\/jats:styled-content>\n testing using a H2 5\u00a0ppm cutoff may identify a subgroup of\n IBS<\/jats:styled-content>\n patients with\n SIBO<\/jats:styled-content>\n . Pilot data examining the clinical response to rifaximin suggest that this subset of\n IBS<\/jats:styled-content>\n patients may benefit more than those with a normal test.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nmo.12331","type":"journal-article","created":{"date-parts":[[2014,3,18]],"date-time":"2014-03-18T22:16:44Z","timestamp":1395181004000},"page":"794-802","source":"Crossref","is-referenced-by-count":66,"title":["A study of the methodological and clinical validity of the combined lactulose hydrogen breath test with scintigraphic oro\u2010cecal transit test for diagnosing small intestinal bacterial overgrowth in\n IBS<\/scp>\n patients"],"prefix":"10.1111","volume":"26","author":[{"given":"J.","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou China"},{"name":"Division of Gastroenterology & Hepatology Tongde Hospital of Zhejiang Province Hangzhou 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