Breath Tests for the Non-invasive Diagnosis of Small Intestinal Bacterial Overgrowth: A Systematic Review With Meta-analysis.
Breath tests
Glucose
Hydrogen
Lactulose
SIBO
Journal
Journal of neurogastroenterology and motility
ISSN: 2093-0879
Titre abrégé: J Neurogastroenterol Motil
Pays: Korea (South)
ID NLM: 101530189
Informations de publication
Date de publication:
30 Jan 2020
30 Jan 2020
Historique:
received:
22
05
2019
revised:
29
08
2019
accepted:
20
09
2019
pubmed:
20
11
2019
medline:
20
11
2019
entrez:
20
11
2019
Statut:
ppublish
Résumé
Small intestinal bacterial overgrowth (SIBO) diagnosis is usually based on non-invasive breath tests (BTs), namely lactulose BT (LBT) and glucose BT (GBT). However, divergent opinions and problems of parameter standardization are still controversial aspects. We aim to perform a meta-analysis to analyze diagnostic performance of LBT/GBT for SIBO diagnosis. We searched in main literature databases articles in which SIBO diagnosis was achieved by LBT/GBT in comparison to jejunal aspirate culture (reference gold standard). We calculated pooled sensitivity, specificity, positive, and negative likelihood ratios and diagnostic odd ratios. Summary receiver operating characteristic curves were drawn and pooled areas under the curve were calculated. We selected 14 studies. 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. When delta over baseline cut-off > 20 H 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 > 20 ppm. BTs demonstrate the best effectiveness in patients with surgical reconstructions of gastrointestinal tract.
Sections du résumé
BACKGROUND/AIMS
OBJECTIVE
Small intestinal bacterial overgrowth (SIBO) diagnosis is usually based on non-invasive breath tests (BTs), namely lactulose BT (LBT) and glucose BT (GBT). However, divergent opinions and problems of parameter standardization are still controversial aspects. We aim to perform a meta-analysis to analyze diagnostic performance of LBT/GBT for SIBO diagnosis.
METHODS
METHODS
We searched in main literature databases articles in which SIBO diagnosis was achieved by LBT/GBT in comparison to jejunal aspirate culture (reference gold standard). We calculated pooled sensitivity, specificity, positive, and negative likelihood ratios and diagnostic odd ratios. Summary receiver operating characteristic curves were drawn and pooled areas under the curve were calculated.
RESULTS
RESULTS
We selected 14 studies. 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. When delta over baseline cut-off > 20 H
CONCLUSIONS
CONCLUSIONS
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 > 20 ppm. BTs demonstrate the best effectiveness in patients with surgical reconstructions of gastrointestinal tract.
Identifiants
pubmed: 31743632
pii: jnm19113
doi: 10.5056/jnm19113
pmc: PMC6955189
doi:
Types de publication
Meta-Analysis
Langues
eng
Pagination
16-28Références
Indian J Gastroenterol. 2006 Jan-Feb;25(1):6-10
pubmed: 16567886
PLoS Med. 2009 Jul 21;6(7):e1000100
pubmed: 19621070
Ann Gastroenterol. 2017;30(4):380-392
pubmed: 28655974
Am J Gastroenterol. 2002 May;97(5):1113-26
pubmed: 12014715
J Am Geriatr Soc. 1992 Jul;40(7):692-6
pubmed: 1607585
Gastroenterology. 1990 Feb;98(2):302-9
pubmed: 2295385
Aliment Pharmacol Ther. 2013 Jun;37(11):1103-11
pubmed: 23574267
Lancet. 1998 Oct 10;352(9135):1187-9
pubmed: 9777836
Neurogastroenterol Motil. 2018 Nov;30(11):e13494
pubmed: 30328232
Br J Rheumatol. 1995 Mar;34(3):265-9
pubmed: 7728404
Aliment Pharmacol Ther. 2013 Oct;38(7):674-88
pubmed: 23957651
Expert Rev Gastroenterol Hepatol. 2016;10(2):215-27
pubmed: 26636484
J Clin Epidemiol. 2005 Sep;58(9):882-93
pubmed: 16085191
Indian J Clin Biochem. 2017 Mar;32(1):84-89
pubmed: 28149017
BMC Med Res Methodol. 2006 Jul 12;6:31
pubmed: 16836745
Dig Dis Sci. 1997 Jan;42(1):10-8
pubmed: 9009110
J Neurogastroenterol Motil. 2011 Jul;17(3):312-7
pubmed: 21860825
Neurogastroenterol Motil. 2018 Nov;30(11):e13350
pubmed: 29687525
Neurogastroenterol Motil. 2015 Apr;27(4):481-9
pubmed: 25600077
Curr Gastroenterol Rep. 2016 Feb;18(2):8
pubmed: 26780631
Clin Gastroenterol Hepatol. 2014 Dec;12(12):1964-72; quiz e119-20
pubmed: 24095975
JAMA. 2018 Jan 23;319(4):388-396
pubmed: 29362800
Ann Intern Med. 2011 Oct 18;155(8):529-36
pubmed: 22007046
Korean J Gastroenterol. 2010 Oct;56(4):242-8
pubmed: 20962560
Clin Exp Rheumatol. 2014 Nov-Dec;32(6 Suppl 86):S-82-7
pubmed: 25372792
BMC Gastroenterol. 2009 Jul 30;9:61
pubmed: 19643023
Gerontology. 1996;42(1):40-5
pubmed: 8641600
Aliment Pharmacol Ther. 2009 Mar 30;29 Suppl 1:1-49
pubmed: 19344474
Neurogastroenterol Motil. 2017 Jun;29(6):null
pubmed: 28191721
Ann Surg. 2015 Nov;262(5):803-7; discussion 807-8
pubmed: 26583669
J Gastroenterol. 2018 Jul;53(7):807-818
pubmed: 29761234
J Gastroenterol. 2009;44(9):944-51
pubmed: 19551459
Clin Transl Gastroenterol. 2018 Apr 25;9(4):146
pubmed: 29691369
Am J Gastroenterol. 2017 May;112(5):775-784
pubmed: 28323273
Gastroenterology. 1986 Dec;91(6):1447-51
pubmed: 3770368
Gut. 1990 Aug;31(8):879-82
pubmed: 2387510
Scand J Gastroenterol. 2016 Mar;51(3):277-80
pubmed: 26375876
J Nutr. 2000 Dec;130(12):2897-902
pubmed: 11110843
J Pediatr Gastroenterol Nutr. 2017 Apr;64(4):541-545
pubmed: 27276436
Digestion. 2012;85(3):243-7
pubmed: 22472730
Gastroenterol Hepatol. 2019 Jan;42(1):1-10
pubmed: 30197248
Dig Dis Sci. 2008 Jun;53(6):1443-54
pubmed: 17990113
Digestion. 2000;61(3):165-71
pubmed: 10773721
Gastroenterol Clin North Am. 2018 Mar;47(1):193-208
pubmed: 29413012
Eur J Gastroenterol Hepatol. 2014 Jul;26(7):753-60
pubmed: 24849768
Chemotherapy. 2005;51 Suppl 1:1-22
pubmed: 15855746
Neurogastroenterol Motil. 2011 May;23(5):e191-6
pubmed: 21324050
Curr Drug Targets. 2014;15(8):762-70
pubmed: 24909808
J Neurogastroenterol Motil. 2015 Oct 1;21(4):545-51
pubmed: 26351251
Scand J Gastroenterol. 1994 Sep;29(9):826-32
pubmed: 7824863
J Pediatr (Rio J). 2018 Sep - Oct;94(5):483-490
pubmed: 29049893
Gastroenterology. 1988 Oct;95(4):982-8
pubmed: 3410238