{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:23:22Z","timestamp":1792628602253,"version":"4.5.0"},"reference-count":36,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[2010,10,24]]},"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Recent studies using the lactulose hydrogen breath test (LHBT) suggest most patients with irritable bowel syndrome (IBS) have small intestinal bacterial overgrowth (SIBO). However, the validity of the LHBT has been questioned, particularly as this test could reflect changes in oro-caecal transit. Therefore, we combined oro-caecal scintigraphy with LHBT in 40 patients who were Rome II positive for IBS to determine if the increase in hydrogen is due to the test meal reaching the caecum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      Patients ingested the test meal containing\n                      <jats:sup>99m<\/jats:sup>\n                      Tc and 10\u2005g lactulose and simultaneous measurements of the location of the test meal using scintigraphic scanning and breath hydrogen levels were obtained every 10\u2005min for 3\u2005h. The LHBT was considered positive when the rise in H\n                      <jats:sub>2<\/jats:sub>\n                      above baseline was &gt;20 ppm within 90 and\/or 180\u2005min. The combined test was negative for SIBO if \u22655% of the test meal was in the caecum at the time the LHBT was positive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      63% had an abnormal LHBT at 180\u2005min and 35% at 90\u2005min. The oro-caecal transit time based on scintigraphic scanning ranged from 10 to 220\u2005min and correlated with IBS sub-type. At the time of increase in H\n                      <jats:sub>2<\/jats:sub>\n                      , the % accumulation of\n                      <jats:sup>99m<\/jats:sup>\n                      Tc in the caecum was \u22655% in 88% of cases (22\/25).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      These findings demonstrate that an abnormal rise in H\n                      <jats:sub>2<\/jats:sub>\n                      measured in the LHBT can be explained by variations in oro-caecal transit time in patients with IBS and therefore do not support the diagnosis of SIBO.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gut.2009.205476","type":"journal-article","created":{"date-parts":[[2010,11,26]],"date-time":"2010-11-26T21:17:29Z","timestamp":1290806249000},"page":"334-340","source":"Crossref","is-referenced-by-count":261,"title":["Combined oro-caecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS"],"prefix":"10.1136","volume":"60","author":[{"given":"Derek","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Cheeseman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Vanner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2010,11,26]]},"reference":[{"key":"2025090711182872000_60.3.334.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2006.01217.x"},{"key":"2025090711182872000_60.3.334.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.01437.x"},{"key":"2025090711182872000_60.3.334.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(05)00157-6"},{"issue":"Suppl 3","key":"2025090711182872000_60.3.334.4","first-page":"S3","article-title":"Bacterial concepts in irritable bowel syndrome","volume":"5","author":"Lin","year":"2005","journal-title":"Rev Gastroenterol Disord"},{"key":"2025090711182872000_60.3.334.5","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-007-0076-1"},{"key":"2025090711182872000_60.3.334.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.00230.x"},{"key":"2025090711182872000_60.3.334.7","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.133629"},{"key":"2025090711182872000_60.3.334.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01798.x"},{"key":"2025090711182872000_60.3.334.9","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1053\/j.gastro.2003.08.038","article-title":"Lactulose breath testing, bacterial overgrowth, and IBS: just a lot of hot air?","volume":"125","author":"Hasler","year":"2003","journal-title":"Gastroenterology"},{"key":"2025090711182872000_60.3.334.10","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00042737-199801000-00011","article-title":"Antibiotic use, childhood affluence and irritable bowel syndrome (IBS)","volume":"10","author":"Mendall","year":"1998","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025090711182872000_60.3.334.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05428.x"},{"key":"2025090711182872000_60.3.334.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2000.03368.x"},{"key":"2025090711182872000_60.3.334.13","first-page":"412","article-title":"Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study","volume":"98","author":"Pimentel","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"2025090711182872000_60.3.334.14","doi-asserted-by":"publisher","DOI":"10.1023\/A:1021738515885"},{"key":"2025090711182872000_60.3.334.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01785.x"},{"key":"2025090711182872000_60.3.334.16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.40795.x"},{"key":"2025090711182872000_60.3.334.17","first-page":"546","article-title":"Investigation of small bowel transit time in man utilizing pulmonary hydrogen (H2) measurements","volume":"85","author":"Bond","year":"1975","journal-title":"J Lab Clin Med"},{"key":"2025090711182872000_60.3.334.18","first-page":"1795","article-title":"The lactulose breath hydrogen test and small intestinal bacterial overgrowth","volume":"91","author":"Riordan","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"2025090711182872000_60.3.334.19","doi-asserted-by":"publisher","DOI":"10.1023\/A:1013208713670"},{"key":"2025090711182872000_60.3.334.20","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3109\/00365527909179892","article-title":"The lactulose hydrogen breath test as a diagnostic test for small-bowel bacterial overgrowth","volume":"14","author":"Rhodes","year":"1979","journal-title":"Scand J Gastroenterol"},{"key":"2025090711182872000_60.3.334.21","doi-asserted-by":"publisher","DOI":"10.1136\/gut.26.8.834"},{"key":"2025090711182872000_60.3.334.22","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.075127"},{"key":"2025090711182872000_60.3.334.23","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.7.852"},{"key":"2025090711182872000_60.3.334.24","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.108712"},{"key":"2025090711182872000_60.3.334.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00498.x"},{"key":"2025090711182872000_60.3.334.26","first-page":"201","article-title":"Scintigraphic determination of the effect of metoclopramide and morphine on small intestinal transit time","volume":"3","author":"Prokop","year":"1988","journal-title":"Am J Physiol Imaging"},{"issue":"4 Pt 1","key":"2025090711182872000_60.3.334.27","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/0016-5085(92)90765-Q","article-title":"Production, metabolism, and excretion of hydrogen in the large intestine","volume":"102","author":"Christl","year":"1992","journal-title":"Gastroenterology"},{"issue":"Suppl 1","key":"2025090711182872000_60.3.334.28","first-page":"1","article-title":"Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference","volume":"29","author":"Gasbarrini","year":"2009","journal-title":"Aliment Pharmacol Ther"},{"key":"2025090711182872000_60.3.334.29","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90129-Z"},{"key":"2025090711182872000_60.3.334.30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2672.1992.tb05187.x"},{"key":"2025090711182872000_60.3.334.31","doi-asserted-by":"publisher","DOI":"10.1136\/gut.24.5.405"},{"key":"2025090711182872000_60.3.334.32","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32832ffd9b"},{"key":"2025090711182872000_60.3.334.33","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00574.2004"},{"key":"2025090711182872000_60.3.334.34","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-2570-4"},{"key":"2025090711182872000_60.3.334.35","doi-asserted-by":"crossref","first-page":"557","DOI":"10.7326\/0003-4819-145-8-200610170-00004","article-title":"The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial","volume":"145","author":"Pimentel","year":"2006","journal-title":"Ann Intern Med"},{"key":"2025090711182872000_60.3.334.36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00458.x"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.2009.205476","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T18:18:38Z","timestamp":1757269118000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.2009.205476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11,26]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2011,2,4]]},"published-print":{"date-parts":[[2011,3]]}},"alternative-id":["10.1136\/gut.2009.205476"],"URL":"https:\/\/doi.org\/10.1136\/gut.2009.205476","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.6905956.9783057","asserted-by":"object"}]},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11,26]]}}}