Особенности течения синдрома раздраженного кишечника при присоединении синдрома избыточного бактериального роста

Abstract

Aim: to assess the rate and pattern of the clinical course of small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome (IBS). Patients and Methods: this study enrolled 100 patients aged 18–68 (mean age 33.5 [26; 46.25] years) with established IBS. The patients were divided into two groups. The IBS with diarrhea (IBS+D) group included 54 patients (mean age 36 [23.0; 49.5] years). The IBS without diarrhea (IBS–D) group included 46 patients (mean 37 [24.5; 49.5] years). All patients underwent lactulose hydrogen breath test using Gastroplus+ monitor to establish SIBO. A positive lactulose hydrogen breath test (a rise of ≥ 20 ppm by 90 min with dual-peak profile or a steady growth of ≥ 12 ppm from baseline in hydrogen) suggested SIBO. Medical history, clinical and lab tests, and the parameters of the quality of life (QoL) using SF-36 and QOL questionnaires were evaluated. Results: the occurrence of SIBO in patients with IBS was 32%, i.e., 37% in the IBS+D group and 28% in the IBS–D group. Multivariate analysis has demonstrated that flatulence in IBS increases the chances of having SIBO by 110.9 times. Univariate analysis revealed universal clinical associations of SIBO with bloating, flatulence, nausea, weakness, tearfulness, and irritability in IBS. Hepatic steatosis is typical for IBS with SIBO (OR=1.75, 95% CI 1.01–3.99, p=0.037). The use of loperamide in IBS+D is associated with a 2.2-fold increase in SIBO risk. SIBO in IBS is associated with a reduction in QoL, as demonstrated by most SF-36 scales (physical and emotional health) and QOL. Conclusions: SIMO in IBS mimics exacerbation, thereby resulting in the prescription of inadequate treatment. KEYWORDS: irritable bowel syndrome, small intestinal bacterial overgrowth, hydrogen respiratory test, quality of life. FOR CITATION: Kulygina Yu.A., Osipenko M.F. Course of irritable bowel syndrome associated with small intestinal bacterial overgrowth. Russian Medical Inquiry. 2022;6(5):232–236 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-232-236.