Clinical Study Of Irritable Bowel Syndrome With Small Intestinal Bacterial Overgrowth

Irritable bowel syndrome(IBS)is one of the common disease in gastroenterology.It is a functional disease caused by the action of many pathogenic factors.Small intestinal bacterial overgrowth is closely related to IBS,and currently SIBO is mostly diagnosed by the lactulose hydrogen breath test.There are still many questions about the relationship,interaction and treatment between IBS and SIBO,and a large number of studies are needed to assist in a deeper and more thorough understanding of IBS and SIBO.Objective: This study examined the incidence of SIBO in patients with IBS,analyzed its clinical characteristics,and evaluated the efficacy of rifximide combined with probiotics in patients with IBS with SIBO.Method:Clinical data of 60 patients with IBS(including 42 IBS-D patients and 18 IBS-C patients)who were admitted to the gastroenterology department of the eastern part of the second hospital of hebei medical university from January 2019 to December 2019 were collected.Thirty healthy patients who came to our hospital for routine physical examination during the same period were selected as the healthy control group.The lactulose hydrogen breath test was used to compare the incidence of SIBO between the IBS group and the healthy control group,and between IBS-D group and IBS-C group.Some patients with IBS combined with SIBO were treated with rifximin and saccharomyces boulardii.After treatment,the improvement of symptoms was evaluated and the lactulose hydromethane breath test was reviewed to determine the drug treatment effect.Results:1.A total of 60 patients were included in the IBS group,and the SIBO positive rate was 68.33%(41/60),and 36.67%(11/30)in the healthy control group of 30 patients.The difference between the two groups was statistically significant(P<0.05).2.The measurement of basic methane in the IBS group was significantly higher than healthy control group(P<0.05),and there was no statistical difference between the two groups in the measurement of basic hydrogen(P > 0.05).3.Among the patients in the IBS group,there were 41 IBS-D patients(68.33%,41/60),and the SIBO positive rate was 68.29%(28/41).There were 19 patients with IBS-C(31.67%,19/60),and the SIBO positive rate of 68.42%(13/19),with no statistically significant difference between the two groups(P>0.05).4.There was no statistically significant difference in symptom assessment between IBS with SIBO and IBS without SIBO,and between different subtypes of IBS who were associated with SIBO(P >0.05).5.Rifaximin and probiotics treated 22 IBS patients with SIBO,with a high effective rate of 45.45%,the total effective rate of symptom improvement was 86.36%.Conclusion:1.The incidence of SIBO in IBS patients was significantly higher than that in the healthy control group,and the basal methane value in IBS patients was significantly higher than that in the healthy control group.2.There was no statistical difference in SIBO positive rate between IBS-D and IBS-C,and there was no correlation between IBS type and severity of symptoms with SIBO.3.Rifximine and probiotics can clearly improve abdominal discomfort symptoms such as abdominal pain and distension in patients with IBS combined with SIBO,and can also change the defecation frequency and stools.