Celiac.com Sponsor (A1):

Celiac.com Sponsor (A1-m):

  • You've found your Celiac Tribe! Join our like-minded, private community and share your story, get encouragement and connect with others.


    • Sign In
    • Sign Up
  • Jefferson Adams

    Breath Tests for the Non-invasive Diagnosis of Small Intestinal Bacterial Overgrowth: A Systematic Review With Meta-analysis

    Jefferson Adams
    Reviewed and edited by a celiac disease expert.

      Researchers work toward a consensus standard for non-invasive breath tests used to diagnose SIBO

    Image: CC BY-SA 2.0--quinn.anya
    Caption: Image: CC BY-SA 2.0--quinn.anya

    Celiac.com 01/31/2020 - We've written previously about the connection between SIBO and rosacea, along with efforts to develop a breath test for celiac disease.

    Diagnosis for small intestinal bacterial overgrowth (SIBO) is usually made using non-invasive breath tests (BTs), namely lactulose BT (LBT) and glucose BT (GBT). However, there is no consensus opinion on the best way to standardize the test parameters. In an effort to move toward a consensus opinion, a team of researchers recently set out to perform a meta-analysis to analyze diagnostic performance of LBT/GBT for SIBO diagnosis. 

    Celiac.com Sponsor (A12):

    Celiac.com Sponsor (A12-m):

    The research team included Giuseppe Losurdo, Gioacchino Leandro, Enzo Ierardi, Francesco Perri, Michele Barone, Mariabeatrice Principi, and Alfredo Di Leo. They are variously affiliated with the Section of Gastroenterology in the Department of Emergency and Organ Transplantation at the University “Aldo Moro” in Piazza Giulio Cesare in Bari, Italy; the Gastroenterology Unit at the National Institute of Research for Gastroenterology “Saverio De Bellis," Castellana Grotte, in Bari, Italy; and with the Digestive Endoscopy Unit, National Institute of Research “Casa Sollievo della Sofferenza,” in San Giovanni Rotondo, Foggia, Italy

    The researchers reviewed medical literature databases for articles that focused on successful SIBO diagnosis via LBT/GBT in comparison to jejunal aspirate culture, which is the reference gold standard. The team calculated pooled sensitivity, specificity, positive, and negative likelihood ratios and diagnostic odd ratios.  They then drew summary receiver operating characteristic curves, and calculated the pooled areas under each curve.

    They chose 14 studies in all, and found that pooled sensitivity of LBT and GBT was 42.0% and 54.5%, respectively. Pooled specificity of LBT and GBT was 70.6% and 83.2%, respectively. 

    In patients with abdominal surgery history, pooled GBT sensitivity and specificity seemed to offer better performance, with levels of 81.7% and 78.8% compared to sensitivity of 40.6% and specificity of 84.0% for subjects with no SIBO predisposing condition.

    Overall, GBT seems to work better than LBT. A cut-off of delta H2 expired other than and lower than 20 ppm shows a slightly better result than above 20 ppm. From these data, the team concludes that great tests are the most effective way to assess patients with surgical reconstructions of gastrointestinal tract.

    Read more in the Journal of Neurogastroenterol Motil. 2020 Jan; 26(1): 16–28


    User Feedback

    Recommended Comments

    There are no comments to display.

    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Add a comment...

    ×   Pasted as rich text.   Restore formatting

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.

  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):

    Celiac.com Sponsors (A17-m):

  • Related Articles

    Jefferson Adams
    Celiac.com 09/03/2009 - Every night thousands of people lose sleep because of a gnawing, tingling urge to move their legs, disturbing their sleep and are often causing chronic pain. These people wake feeling unrested, with aching muscles.
    In addition to lost sleep and discomfort, these people often suffer chronic pain. Often, these symptoms baffle both patients and primary care doctors. Little do these people and their doctors know that the pain and restlessness is due to Restless Legs Syndrome (RLS) and is likely caused by a problem with the digestive tract.
    RLS affects 7% to 15% of the population, especially older adults and pregnant women. RLS...

    Jefferson Adams
    Celiac.com 02/24/2016 - Rosacea is a common inflammatory skin condition that shares the same genetic risk location as autoimmune diseases such as type 1 diabetes mellitus (T1DM) and celiac disease.
    Researchers have noted a clustering of autoimmune diseases in patients with rosacea. In fact, a recent genomewide association study found 90 genetic areas associated with T1DM, celiac disease, multiple sclerosis, and/or rheumatoid arthritis, but did not address a possible association with rosacea.
    A team of researchers recently set out to assess any connections between rosacea and T1DM, celiac disease, multiple sclerosis, and rheumatoid arthritis, respectively...

    Jefferson Adams
    Celiac.com 04/30/2018 - Rosacea is one of the most common skin diseases, and usually manifests as chronic inflammation of the eyes and the central part of the face. Rosacea is medically harmless, but it can trigger strong self-consciousness and reduce people’s overall enjoyment of life. For most people, symptoms of rosacea include flushing and erythrosis or reddening of the face. A small percentage of patients also get the formation of papules and pustules, with phymata.
    Doctors have posited numerous possible triggers, including hypochlorhydria, dysmotility, anatomic anomalies of the intestine, and immunologic causes. SIBO is an acronym for small in...

    Jefferson Adams
    Celiac.com 05/20/2019 - A stuffy and obscure-sounding scientific paper has more than a few people excited about a breakthrough breath test to help manage diabetes, celiac disease and other conditions.
    Celiac is one of the most common and misdiagnosed disease. The process of getting a proper diagnosis can be long and convoluted. In part, that's because people with celiac disease may have few or no symptoms. In fact, these days, most people diagnosed with celiac disease report few or no symptoms.
    In fact, it's not at all uncommon for a person with celiac disease to suffer for up to 10 years before getting a proper celiac diagnosis.