Analysis Of Clinical Characteristics Of Intestinal Bacterial Overgrowth In Patients With Functional Gastrointestinal Disorders

Objective: To investigate the clinical characteristics of patients with functional gastrointestinal disorders（FGIDs）with intestinal bacterial overgrowth（SIBO）,including the gender,age,body mass index,clinical symptoms,orocecal transit time,and to explore the correlation between SIBO and clinical characteristics of patients with FGIDs.Methods: A total of 228 patients with FGIDs were divided into three groups according to their clinical symptoms: gastroesophageal symptom group（with the acid regurgitation heartburn and belching symptoms）and intestinal symptom group（with diarrhea,constipation,alternate diarrhea and constipation,abdominal distension symptoms）.All the patients included in this study were tested for SIBO by Lactulose hydrogen and methane breath test（LHMBT）.Based on the results of this test,the patients were divided into SIBO positive group and SIBO negative group.The clinical data of patients in SIBO positive and negative group were analyzed,and the odds ratio（OR）and 95% confidence interval（CI）of each clinical symptom of patients in SIBO positive group were calculated.The orocecal transit time（OCTT）was compared between SIBO-positive and SIBO-negative patients with various clinical symptoms.Then the SIBO positive patients were treated with rifoximine tablets with low dose and short course of treatment,and the Gastrointestinal Symptom Rating Scale（GSRS）of SIBO positive patients before and after treatment was analyzed.Results: 228 patients with FGIDs who met the diagnostic criteria of Rome IV received LHMBT,and 124 patients with positive breath test（54.4%）indicated that these patients had SIBO.There was no significant difference in the gender,age and Body Mass Index（BMI）between patients in SIBO positive group and SIBO negative group,but there was significant difference in clinical symptoms between patients in the two groups（P < 0.05）.The odds ratio [OR] and 95% confidence interval [CI] of patients with acid regurgitation heartburn in SIBO positive group were 0.156 and[0.075-0.325] respectively;The odds ratio [OR] and 95% confidence interval [CI] of belching patients were 4.764 and [1.888-12.021],respectively.The odds ratio [OR]and 95% [CI] of diarrhea patients was 2.013 and [1.050-3.857],respectively;The odds ratio [OR] and 95% [CI] of constipation patients was 5.349 and [1.522-18.803],respectively;The odds ratio [OR] was 0.673 and 95% [CI] was [0.278-1.626] in patients with alternating diarrhea and constipation;The odds ratio [OR] was 0.683 and95% [CI] was [0.362-1.288] in patients with abdominal distension.In the belching group,the OCTT of SIBO positive patients was significantly longer than that of SIBO negative patients（t=4.362,P < 0.01）;In diarrhea group,the OCTT of SIBO positive patients was shorter than that of SIBO negative patients（t=-2.540,P < 0.05）;In constipation patients,the OCTT of SIBO positive patients was significantly longer than that of SIBO negative patients（t=5.073,P < 0.01）;In abdominal distension group,the OCTT of SIBO positive patients was longer than that of SIBO negative patients（t=2.902,P < 0.01）;There was no significant difference in OCTT between SIBO positive patients and SIBO negative patients in acid regurgitation heartburn,diarrhea and constipation alternate patients.After the treatment of SIBO with rifoximine tablets,the clinical symptoms of all patients with FGIDs were improved in different degrees.The GSRS score before treatment decreased from（28.91 ± 3.82）to（18.81 ± 2.85）after treatment,the difference was statistically significant（t=5.847,P< 0.05）;There was no significant difference in GSRS scores of patients among each clinical symptom group（P > 0.05）.Conclusion: FGIDs were closely related to SIBO,belching,diarrhea,constipation as the main symptoms were more likely to have SIBO in patients with FGIDs.SIBO may cause most of the clinical symptoms in patients with FGIDs by accelerating or slowing down gastrointestinal motility.Treatment of SIBO with rifaximin at a low dose and short course of treatment can improve the clinical symptoms of patients with FGIDs.