WHAT IS BACTERIAL OVERGROWTH?
El small intestine bacterial overgrowth (SIBO) is characterized by an increase in the number or a change in the type of bacteria that grows in the small intestine. SIBO can be marked by the overgrowth of pathogenic bacteria or beneficial bacteria, but any form of increased intestinal flora it becomes detrimental to gastrointestinal and systemic health.
SIBO has been a topic of interest in the international gastroenterology community since the late 1990s, and awareness of what augmented bacterial flora means has spread rapidly in the last decade. Despite the general medical consensus on causes, manifestations, and treatments for SIBO, many aspects of this condition remain a mystery.
WHY IS THERE BACTERIAL OVERGROWTH (SIBO)?
Causes SIBO they are varied and are still under active investigation. It is known that the bacterial overgrowth syndrome It develops when one or more defense mechanisms against bacterial overgrowth are compromised.
These defense mechanisms include:
- Hydrochloric acid to destroy bacteria in the stomach.
- Intestinal motility to keep intestinal contents moving forward.
- Immunoglobulins and pancreatic proteolytic enzymes to stop bacterial growth.
- The ileocecal valve intact to prevent the reflux of the contents of the large intestine into the small intestine.
Thus, the risk factors for SIBO are those that can compromise the different defense mechanisms: achlorhydria, chronic use of acid-blocking drugs, chronic pancreatitis, diabetic neuropathy and immunodeficiency, alteration of the migratory motor complex (MMC), creating waves of smooth muscle contraction to cleanse the gastrointestinal tract, is another major risk factor.
SIBO has also been found to be more prevalent in patients with other gastrointestinal disorders, such as celiac disease, Crohn's disease, and irritable bowel syndrome (IBS), than in the general population.
DISORDERS THAT IT CAUSES:
What is meant by increased intestinal flora translates into symptoms derived from three different aspects that can develop depending on the intensity and prolongation of the problem over time:
-Symptoms derived from the fermentation of short chain carbohydrates (sugars): they usually involve nonspecific digestive symptoms. Chronic diarrhea, constipation, bloating, cramps, nausea, acid reflux, flatulence, and belching are common. The digestive symptoms of SIBO are often indistinguishable from the digestive symptoms of IBS or other functional digestive disorders.
-Symptoms derived from a defect in absorption: as SIBO progresses or is prolonged over time, signs of malabsorption may predominate, such as steatorrhea, weight loss, malnutrition, or osteoporosis. In some cases, abnormal laboratory results are the first clue to the presence of SIBO: iron deficiency anemia, marked by low levels of ferritin, can be the result of a combination of occult blood loss and bacterial absorption of iron through intestinal level. Vitamin B12 deficiency can also be the result of bacterial absorption, producing macrocytic anemia. Malabsorption contributes to fat-soluble vitamin deficiencies, including vitamins A, E, and D. Conversely, levels of vitamin K and folic acid can increase as a result of bacterial synthesis.
-Systemic symptoms may also appear due to the alteration of the function of the intestinal barrier. that is, increased intestinal permeability, with joint pain, skin rashes, mood swings, fatigue, hypersensitivity processes and food allergy or autoimmune diseases coexisting.
HOW CAN I KNOW IF I HAVE BACTERIAL OVERGROWTH?
Breath tests are based on the concept that ingested sugars will be fermented by bacteria in the small intestine, creating gases (hydrogen and / or methane) that diffuse into the bloodstream and are released into the exhaled air. Hydrogen and methane are produced exclusively in the large intestine in healthy humans, but they are also produced in the small intestine in SIBO patients.
Certain bacteria, including Enterobacteriaceae, Bacterioides, and Clostridium, produce primarily hydrogen rather than methane. Other bacteria, called methanogenic, produce mainly methane. These are members of the Archaea domain, including the Methanobrevibacter and Methanospaere species. The United States Consensus Group recommends that hydrogen, methane, and carbon dioxide be measured simultaneously during breath tests.
That said, the test can be performed using glucose, lactulose or lactitol as a substrate.
The bacterial overgrowth test with lactulose is identical to that of lactitol since they are two substrates that act identically, so from now on everything that refers to the lactulose test will also be valid for the lactitol test.
It is based on the fact that glucose will be fully absorbed in the small intestine of all people. That is, glucose will never reach the large intestine. In this way, what happens when the bacterial flora is increased in the small intestine is that, after the ingestion of a controlled amount of glucose, there will be a peak in the concentration of hydrogen and / or methane due to the fermentation produced. at this level and therefore we would obtain a positive glucose test for SIBO.
Unlike the glucose test, it is based on the fact that lactulose is not absorbed at all in the small intestine and the entire amount ingested will reach the large intestine intact. Thus, in a positive lactulose test, two peaks will be obtained in the concentrations of hydrogen and / or methane, one corresponding to the fermentation produced by the excess flora of the small intestine and the other to that of the flora of the large intestine.
One of the advantages of the lactulose test over the glucose test is that, as SIBO is more likely to develop in the more distal portion of the small intestine, as glucose is absorbed in the proximal small intestine and lactulose traverses all the way until the colon, it is possible that using the glucose test some SIBO is not detected because it has been absorbed before making contact with the area in which the flora is increased.
WHAT ADVANTAGES DOES OUR BREATH TEST PROVIDE FOR BACTERIAL OVERGROWTH?
It is the aspirated air test that has the great advantage of evaluating hydrogen, methane and carbon dioxide at the same time. This circumstance allows AIRTEST to significantly reduce the number of false negatives and have control over the quality of the sample, compared to other breath tests that only quantify hydrogen.
- Not having consumed any antibiotics, performed colonoscopy, barium enema, capsule endoscopy or enteroscopy during the 30 days prior to the test.
- 24 hours before you have to follow a diet without fiber (you cannot eat fruits, vegetables, legumes, cold cuts, carbonated drinks and whole foods).
You can eat grilled meat or fish, eggs, pasta without sauces, white rice and toast. For dinner you can only eat grilled meat or fish and a French omelette.
- Do not brush your teeth, smoke, paint your lips, drink water, or eat food for 8 hours prior to the test.
- Do not do physical exercise for at least 30 minutes prior to the test.
- If you are suffering from diarrhea, it is better to postpone the test or consult your doctor.
WHAT DOES IT CONSIST OF AND HOW LONG DOES THE TEST LAST?
This test consists of measuring the hydrogen and methane concentration in the exhaled air before and after administering a solution with a certain amount of lactitol orally, at intervals of 25 minutes to 175 minutes, for which the patient will stay for approximately 3 hours. In our instalations.
Results will be available in 7 business days.
I NEED A BACTERIAL OVERGROWTH NETWORK (SIBO) WHAT SHOULD I DO?
To perform a BACTERIAL OVERGROWTH NETWORK (SIBO):
- Comply with the conditions prior to carrying out the AIRTEST.
- We will contact you to give you an appointment.