Irritable Bowel Syndrome Message Boards | Looking at the full paper ...

it says "Of the initial 320 subjects, 112 were IBS sufferers; 35 patients (31.2%) had IBS-D; 19 patients (16.9%) had IBSC; and 58 patients (51.8%) had IBS-A."

518 patients were screened and 320 subjects were enrolled if the met the inclusion criteria stated as "Inclusion criteria were: (a) age C18 years, and (b) clinical indication for outpatient upper GI tract endoscopy." There were a variety exclusion criteria including such things as recent antibiotic use, HIV and hypothyroidism. In other words, individuals were not enrolled solely because they had IBS or SIBO. They were enrolled because they were having an endoscopy.

"Before undergoing upper GI tract endoscopy, patients were asked to provide replies to a specific questionnaire trying to disclose the presence of IBS." The ROME II criteria was used to diagnosis enrolled individuals for IBS.

"Of the initial 320 subjects, 112 were IBS sufferers; 35 patients (31.2%) had IBS-D; 19 patients (16.9%) had IBSC; and 58 patients (51.8%) had IBS-A. Reasons for upper GI tract endoscopy among IBS patients were dyspepsia in 75 patients (66.9%), anemia in 24 patients (21.4%) and change of bowel frequency in nine patients (8.0%); the remaining patients had a list of other uncommon complaints."

During the endoscopy fluid samples were taken from 3rd part of the duodenum and cultured. "The most common bacterial species isolated from the duodenal aspirate of the 62 atients with SIBO were Escherichia coli (n = 23; 37.1%), Enterococcus spp (n = 20; 32.3%), Klebsiella pneumoniae (n = 15; 24.2%), Proteus mirabilis (n = 4; 6.5%), Acinetobacter baumannii (n = 3; 4.8%), Citrobacter freundii (n = 3; 4.8%), Serratia marscecens (n = 3; 4.8%), Staphylococcus aureus (n = 2; 2.9%), Pseudomonas putida (n = 2; 2.9%), Pasteurella multocida (n = 2; 2.9%) and Enterobacter aerogenes (n = 1; 1.6%)."

"Among these IBS subjects, 42 (37.5%) met the applied definition for SIBO." So of the 360 enrolled individuals 112 had IBS according to the ROME criteria and 37.5% of these meet the definition of SIBO. And "The frequency of SIBO was much greater among patients with IBS-D. More precisely, 33.8% of patients with SIBO were sufferers of IBS-D compared with 5.4% of patients without SIBO (P\0.0001) (Table 1)."

"Examining the relationship between SIBO and IBS, among the 62 patients with SIBO, 42 had IBS (67.7%). This was greater than the 258 patients without SIBO, whereby only 70 had IBS (27.1%) (Mantel�Haenszel common odds ratio estimate: 5.64; 95% CI 3.09�10.27; P\0.0001)."

This is not "definitive" evidence that bacteria can play a role in IBS. Given no methodological errors it is strong evidence that in a subset of individuals diagnosed with IBS using the ROME II criteria, particularly those with IBS-D, that bacteria likely plays a role.

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