糖呼吸测试对SIBO，果糖和乳糖不耐症的诊断实用性。,Digestive Diseases and Sciences

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糖呼吸测试对SIBO，果糖和乳糖不耐症的诊断实用性。
Digestive Diseases and Sciences ( IF 2.5 ) Pub Date : 2019-10-15 , DOI: 10.1007/s10620-019-05889-9
Mercedes Amieva-Balmori _{1,

2} , Enrique Coss-Adame _{1,

3} , Nikilesh S Rao ₁ , Brisa M Dávalos-Pantoja ₁ , Satish S C Rao ₁

Affiliation

背景技术无法解释的腹胀，气体和疼痛是常见症状。如果常规检查为阴性，则此类患者通常被标记为肠易激综合症。目的确定呼吸测试的诊断效用，以评估小肠细菌过度生长（SIBO），果糖或乳糖不耐受症以及症状的预测价值。方法采用症状问卷，葡萄糖（75克），果糖（25克）或乳糖（25克）呼气试验评估患有气，腹胀，腹泻，腹痛（≥6个月）且内镜和放射学检查阴性的患者。当H2（≥20 ppm）或CH4（≥15 ppm）增加到基线值以上时，呼吸测试被分类为阳性；而当症状显着变化而没有升高H2 / CH4时，呼吸测试被分类为超敏反应，或者被分类为阴性。结果1230名患者（女性= 878）接受了2236次呼气测试。SIBO的患病率为33％（294/883），果糖不耐受率为34％（262/763），乳糖不耐受率为44％（260/590）。在果糖和乳糖呼气试验中，超敏反应的发生率分别为16％和9％。尽管气体（89％），腹痛（82％）和腹胀（82％）十分普遍，但预测症状或其严重程度并不能预测呼气试验异常，但是呼气试验期间的症状有助于诊断SIBO，果糖，和乳糖不耐症和超敏反应。结论约有45％的原因不明的气体和腹胀的患者患有SIBO，果糖或乳糖不耐症。另有9-16％的人有内脏超敏反应。测试前的症状是不良的预测指标，但是呼气试验中的症状很有用。呼气测试是安全的，可提供明显的诊断结果，

"点击查看英文标题和摘要"

Diagnostic Utility of Carbohydrate Breath Tests for SIBO, Fructose, and Lactose Intolerance.

BACKGROUND Unexplained bloating, gas, and pain are common symptoms. If routine tests are negative, such patients are often labeled as irritable bowel syndrome. AIMS To determine the diagnostic utility of breath tests that assess for small intestinal bacterial overgrowth (SIBO), fructose or lactose intolerance, and the predictive value of symptoms. METHODS Patients with gas, bloating, diarrhea, abdominal pain (≥ 6 months), and negative endoscopy and radiology tests were assessed with symptom questionnaires, glucose (75 g), fructose (25 g), or lactose (25 g) breath tests. Breath tests were categorized as positive when H2 (≥ 20 ppm) or CH4 (≥ 15 ppm) increased above baseline values or as hypersensitive when symptoms changed significantly without rise in H2/CH4 or as negative. RESULTS 1230 patients (females = 878) underwent 2236 breath tests. The prevalence of SIBO was 33% (294/883), fructose intolerance was 34% (262/763), and lactose intolerance was 44% (260/590). Hypersensitivity was found in 16% and 9%, respectively, during fructose and lactose breath tests. Although gas (89%), abdominal pain (82%), and bloating (82%) were highly prevalent, pretest symptoms or their severity did not predict an abnormal breath test, but symptoms during the breath test facilitated diagnosis of SIBO, fructose, and lactose intolerance and hypersensitivity. CONCLUSIONS Approximately 45% of patients with unexplained gas and bloating had SIBO, fructose, or lactose intolerance; another 9-16% had visceral hypersensitivity. Pretest symptoms were poor predictors, but symptoms during the breath tests were useful. Breath tests are safe, provide significant diagnostic yield, and could be useful in routine gastroenterology practice.

更新日期：2019-11-01

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