{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:17:51Z","timestamp":1781914671761,"version":"3.54.5"},"reference-count":0,"publisher":"Sociedad Argentina de Gastroenterologia","issue":"4","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ACTA"],"abstract":"<jats:p>Small intestinal bacterial overgrowth was originally described as a cause of maldigestion and malabsorption, and its diagnosis was based on the culture of aspirates from the upper small intestine; however, the application of hydrogen breath tests to assess suspected small intestinal bacterial overgrowth dramatically increased the frequency of this diagnosis and expanded its clinical context from maldigestion to include a number of non-specific gastrointestinal complaints and even some systemic conditions. A critical review of recent literature suggests that reliance on breath tests, particularly those using lactulose as the substrate, has led to overdiagnosis of small intestinal bacterial overgrowth, as many aspects of the current diagnostic concept remain contentious and unresolved, including diagnostic thresholds, response to antibiotic therapy, and the roles of methane, hydrogen sulfide, and other gases produced by bacterial fermentation in the gastrointestinal tract. These issues are discussed with particular attention to the concept of intestinal methanogen overgrowth, exploring the role of methanogens and methane in gastrointestinal homeostasis, while advocating for a critical and cautious approach to the diagnosis of both small intestinal bacterial overgrowth and intestinal methanogen overgrowth, careful prescription of antibiotics, and anticipating the application of modern molecular microbiology to the study of the small intestinal microbiome and metabolome, including a more comprehensive understanding of methane biology.<\/jats:p>","DOI":"10.52787\/agl.v55i4.570","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:15:11Z","timestamp":1766517311000},"page":"276-291","source":"Crossref","is-referenced-by-count":1,"title":["Small Intestinal Bacterial Overgrowth and Intestinal Methanogen Overgrowth: Are They Overdiagnosed?"],"prefix":"10.52787","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9006-9053","authenticated-orcid":false,"given":"Anokhi S","family":"Kholwadwala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4151-7180","authenticated-orcid":false,"given":"Eamonn","family":"Quigley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30608","published-online":{"date-parts":[[2025,12,23]]},"container-title":["Acta Gastroenterol\u00f3gica Latinoamericana"],"original-title":[],"link":[{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/570\/910","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/570\/926","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/570\/926","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:15:11Z","timestamp":1766517311000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/view\/570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12,23]]}},"URL":"https:\/\/doi.org\/10.52787\/agl.v55i4.570","relation":{},"ISSN":["2469-1119"],"issn-type":[{"value":"2469-1119","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,23]]}}}