Irritable Bowel Syndrome Message Boards | Re: A New IBS Solution by Mark Pimentel, MD

SIBO (small intesting bacterial overgrowth) which is what Dr Pimentel is talking in his 2005 book about is usually diagnosed using the lactulose breath test.

Recently there have been some research articles published showing that the lactulose breath test (LBT) he uses to diagnose SIBO is unreliable. A recent study Lactulose Breath Testing Does Not Discriminate Patients With Irritable Bowel Syndrome From Healthy Controls shows the test for diagnosing SIBO is questionable. They say "The utility of LBT, in its current form as a diagnostic tool in IBS requires critical reappraisal."

A recent editoral in the American Journal of Gastorenterology titled The Lactulose Breath Test for Diagnosing SIBO in IBS Patients: Another Nail in the Coffin says "The findings of the lactulose breath test in irritable bowel syndrome patients have been used to suggest that most patients have small intestinal bacterial overgrowth (SIBO), and this association has spawned the widespread use of antibiotics in IBS. The study by Bratten and colleagues demonstrates that this test does not discriminate between IBS patients and healthy controls when criteria from recent clinical IBS studies are applied. When the findings from this large study are combined with previous smaller studies, they challenge the hypothesis that SIBO underlies the symptoms of IBS and undermine the current rationale for the use of antibiotics in IBS."

It seems SIBO is a contentious issue with GI docs and it role in IBS may be questionable.

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