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Proton pump inhibitors (PPI’s) can affect the microbiota of the intestinal tract.  As a result, it has been suggested that people taking PPI‘s might be at a higher risk for small intestinal bacterial overgrowth (SIBO).  This hypothesis was tested in a retrospective study of 1,191 patients of which 566 were on PPI therapy.  Each these subjects received a glucose hydrogen breath test to check for the presence of SIBO. The result was no correlation was found that showed taking PPI’s increased the risk for SIBO.  The only increased risk was age – regardless of consumption of PPI’s.

Lactose intolerance and milk allergy are often considered the same problem.  But they are two entirely different medical conditions that require different courses of action.  People with lactose intolerance experience distress after consuming dairy products because they have a lack of an enzyme known as lactase.  This condition can be detected using the hydrogen breath test for lactose intolerance.  If you test positive all is not lost because there are effective strategies for treating lactose intolerance.  These treatments include taking supplements to replace lactase, eating dairy that has lactose removed, and learning through trial and error your level of tolerance.  Milk allergy is a much more serious problem that is caused by an allergic reaction to a specific protein found in milk known as beta-lactoglobulin.  Milk allergy presents with some of the same symptoms as lactose intolerance (ie. Diarrhea) but in many cases includes swelling of the mouth and mucous membranes. About 2 to 3 percent of children are believed to have milk allergy.  There is no treatment for a milk allergy other than avoiding milk.  However, recent research has suggested that high amounts of iron incorporated into the milk protein might protect against the allergen.  Further research is needed to understand how to increase the iron content and to confirm these findings.

The prevalence of H. pylori increases with age. This phenomenon is thought to be due to increased use of medications and decreased secretion of protective prostaglandins...

Previous research has established that small intestinal bacterial overgrowth (SIBO) is common in patients with chronic pancreatitis caused by excessive consumption of alcohol.  This new research examined if SIBO is also prevalent in patients with chronic idiopathic pancreatitis.  68 patients were enrolled in the study – 46 had idiopathic chronic pancreatitis and 22 had alcoholic.  Each subject was tested with the glucose hydrogen breath test.  The result was that there was a high prevalence of SIBO in both types of pancreatitis.

In the past few years the Gluten-Free diet has become very popular.  Part of the popularity is fueled by the idea that while a person may not have celiac disease then may have gluten sensitivity.  As result, these self –diagnosed individuals begin avoiding foods with gluten.  But there is a cost to this decision  – foods with gluten often contain fiber, vitamins and minerals that are necessary in the daily diet. Gluten-free foods often contain refined grains that are often low in nutrients.

Patients with Irritable Bowel Syndrome (IBS) are often diagnosed with small intestinal bacterial overgrowth but seldom tested for carbohydrate malabsorption.  To look at this issue of carbohydrate malabsorption a research group in Germany studied 2,390 IBS patients.  Each patient received a hydrogen breath test for fructose malabsorption and lactose intolerance.  The result was that 35% of the patient tested positive for lactose intolerance and 64% for fructose malabsorption.  This lead the researchers to conclude that lactose and fructose intolerances are a frequent but underestimated condition in patients with IBS symptoms.

Much has been written about the IBS and small intestinal bacterial overgrowth.  Fewer studies have focused on the incidence of lactose intolerance in IBS patient in spite of the fact it is very common for these patient to self perceive that they are lactose intolerant.   A recent study evaluated 51 IBS patients using the hydrogen breath test to ascertain the prevalence of lactose intolerance. A total of 24 of 51 (47%) had a positive hydrogen breath test for lactose intolerance.  Furthermore, the researchers noted that patients with a high severity of IBS were more likely to test positive for lactose intolerance.

A high prevalence of Fructose malabsorption has been reported in previous studies of IBS patient. This research sought to examine whether the findings held up in a statistically significant number of Indian patients.  The study enrolled 97 patients with confirmed IBS using the Rome III criteria and 41 healthy controls.  Each subject was given a hydrogen breath test for Fructose Malabsorption.  The result was that IBS patients tested positive for fructose malabsorption at a statistically significant rate higher as compared to controls.  Furthermore, patients with diarrhea-predominant IBS had a 91% positive rate for fructose malabsorption as measured by the hydrogen breath test.

Good article today http://www.thetimesnews.com/lifestyles/lifestyles-home/understand-the-facts-of-lactose-intolerance-1.348681 about lactose intolerance. Key take home...

The hydrogen breath test shows the bacterial fermentation of unabsorbed intestinal carbohydrates. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome type symptoms such as diarrhea and/or constipation, bloating, excess flatulence, headaches and lack of energy.  When bacteria is present in the small intestine this bacteria will metabolize the carbohydrates producing the IBS like symptoms.  The authors of this research believe that patients with persistent symptoms of abdominal bloating and distension despite dietary intervention should take a hydrogen breath test to determine if they have small intestinal bacterial overgrowth (SIBO).  A proper diagnosis of SIBO can lead to effective treatment of the condition and relief of the IBS symptoms.