Sa1338 The Chracteristics of Positivity to Glucose Breath Test in Patients With Cholecystectomy

Abstract

Objectives: There is a possibility that bacterial overgrowth is associated with postcholecystectomy patients. This study was to evaluate the prevalence and characteristics of small intestinal bacterial overgrowth (SIBO) in patients with intestinal symptoms according to the history of cholecystectomy. Methods: 62 postcholecystectomy patients with intestinal symptoms and 145 functional gastrointestinal disease (FGID) patients, and 30 healthy controls undergoing hydrogen (H2)-methane (CH4) glucose breath test (GBT) were reviewed. The GBT positivity (+) indicating the presence of SIBO, gas types and bowel symptom questionnaire were surveyed. The GBT + were (1) an increase in the breath H2 or CH4 concentration of ≥ 12 ppm over the baseline or (2) a baseline H2 or CH4 concentration of ≥ 15 ppm within 60 min after 50g of glucose load. Results: The GBT +were significantly higher in postcholecystectomy patients (46.8%, 29/62) than those in FGID patients (26.2%, 38/145) (p < 0.01), or those in controls (13.3%, 4/30) (p < 0.01), respectively. Among postcholecystectomy patients, 27 (43.5%), 2 (3.2%), 0 (0%) were in the GBT (H2) +, (CH4) +, (both) + groups, respectively. In the gas types, the GBT (H2) + in postcholecystectomy patients was significantly higher than those in FGID patients (43.5% vs. 20%, p = 0.02). At the single time points of the GBT in postcholecystectomy patients, only the baseline H2 levels were significantly higher in GBT + group than in GBT group, and the GBT + group had higher symptom scores of significance or tendency in abdominal discomfort (p = 0.49), urgency (p = 0.02), bloating (p < 0.01), chest discomfort (p = 0.34), early satiety (p = 0.06) and nausea (p = 0.40) than those of the GBT group. Conclusions: The SIBO with high levels of baseline H2 might be the important etiologic factor of upper intestinal symptoms for postcholecystectomy patients.