Breath hydrogen and methane are associated with intestinal symptoms in patients with chronic pancreatitis.
BACKGROUNDS
The bacterial overgrowth might be associated with chronic pancreatitis. This study was to evaluate the prevalence and characteristics of small intestinal bacterial overgrowth (SIBO) in patients with chronic pancreatitis.


METHODS
36 patients with chronic pancreatitis and 49 healthy controls undergoing the hydrogen (H2)-methane (CH4) lactulose breath test (LBT) were reviewed. The LBT positivity (+) indicating the presence of SIBO, gas types, bowel symptom questionnaire, laboratory and radiologic results were surveyed. The LBT+ was (1) an increase in the breath H2 (≥20 ppm) or CH4 (≥10 ppm) over the baseline or (2) a baseline H2 (≥20 ppm) or CH4 (≥10 ppm) within 90 min after lactulose load.


RESULTS
LBT+ was significantly higher in the patients (17/36) than in controls (13/49) (47.2% vs. 26.5%, P < 0.05). During LBT, the H2 levels between 0 and 105 min were significantly higher in patients than in controls. Among LBT+ patients, 11 (64.7%), 1 (5.9%), 5 (29.4%) were in the LBT (H2)+, (CH4)+, (mixed)+ groups, respectively. The LBT+ group had significantly higher scores of flatus than those of the LBT- group. Considering the subtypes of LBT, the LBT (mixed)+ group had higher symptom scores of significance or tendency in hard stool, strain, urgency, and flatus than LBT- group The laboratory and radiologic features were not significantly different between LBT+ and LBT- groups.


CONCLUSIONS
SIBO is common in patients in chronic pancreatitis. Especially, excretions of mixed H2 and CH4 appear to be related with deterioration of intestinal symptoms.
['Kim|Dae Bum|DB|', 'Paik|Chang-Nyol|CN|', 'Sung|Hea Jung|HJ|', 'Chung|Woo Chul|WC|', 'Lee|Kang-Moon|KM|', 'Yang|Jin-Mo|JM|', 'Choi|Myung-Gyu|MG|']
D000328:Adult D000368:Aged D001424:Bacterial Infections D015415:Biomarkers D001944:Breath Tests D016022:Case-Control Studies D005260:Female D006801:Humans D006859:Hydrogen D007421:Intestine, Small D007792:Lactulose D008297:Male D008697:Methane D008875:Middle Aged D050500:Pancreatitis, Chronic D015995:Prevalence D012189:Retrospective Studies
Hydrogen Methane Intestinal symptom Chronic pancreatitis Breath test