on gastrointestinal motility and symptoms in patients with IBS and healthy volunteers (HV).Methods: We recruited patients with IBS based on ROME III criteria.Celiac disease was excluded by a negative IgA TG2 antibody test and duodenal biopsy (Marsh 0-I).HLA-DQ2/ DQ8 status was determined but was not an inclusion criterion.IBS patients were stratified according to their anti-gliadin antibody (AGA) status.A cohort of healthy volunteers (HV) was used as control.Symptoms and gastrointestinal (GI) transit were studied before and after 1-month of GFD.GI transit was evaluated by modified SHAPE study.We assessed gut symptoms (Birmingham, Bristol scale and GSRS), anxiety and depression (HADs), somatic symptoms (PHQ-15) and dietary habits (DQESV2).Fecal microbiota was analysed by 16S rRNA-based Illumina.GFD instructions and compliance were assessed by a trained dietitian.Results : Thirty five IBS patients (15 AGA+ and 20 AGA-) and 26 healthy volunteers were enrolled.Compared to HV, GI transit normalized after GFD in 42% of IBS AGA+ patients vs 25% in IBS AGA-patients.Overall GI symptoms, particularly indigestion (p=0.02),diarrhea (p=0.008) and abdominal pain (p=0.005)improved after GFD in the IBS AGA+ patients but there were no changes in GI symptoms in IBS AGA-patients.Similarly, depression scores decreased in IBS AGA+ but not in IBS AGA-patients.Overall wellbeing, especially positivity (p=0.007) and vitality (p=0.02),improved in IBS AGA+ but not in IBS AGApatients.Individual shifts in microbiota profiles, with overall mild decrease in Firmicutes/ Bacteroidetes ratio was observed in the IBS AGA+ patients.GFD diet had overall no effect in healthy volunteers, although some of them developed constipation.Conclusions: The results suggest that the stratification by anti-gliadin antibody status can identify a subgroup of IBS patients that respond symptomatically to GFD.The gluten-free diet does not seem to improve GI symptoms, overall wellbeing or gut function in IBS patients without AGA.

INTRODUCTION:Colorectal cancer is a major health problem worldwide because it is the third most common cancer and the third leading cause of cancer mortality in western countries. Screening for colorectal cancer in asymptomatic patients is crucialfor reducing the incidence and colonoscopy is one of the methods of choice. The ability of colonoscopy in detecting small lesions is clearly influenced by the quality of the colonic preparation.OBJECTIVES:To know which are the variablesrelating to the patient and the type ofpreparation that affect the quality of colonic cleansing.MATERIALS AND METHODS:It was designed a cross-sectional study. It was administered a questionnaire for the enrolled subjects to assess the presence offactors that could affect the quality of colonic cleansing. Then they underwent a colonoscopy. The different variables between subjects with adequate or inadequate colonic cleansing were compared.RESULTS:We evaluated 277 subjects. In multivariate analysis the only variables that showed significant differences are split dose [OR 0.45 (0.21 to 0.99)] and age [OR 1.02 (1-1.05)]. Obesity showed no significant differences in multivariate analysis [OR 1.84 (0.9-3.78)].CONCLUSIONS:Age and split-dose were the only variables significantly associated with the quality of bowel preparation prior to colonoscopy. Not so constipation or the presence ofdiverticula, so these patients do not require special preparation regimes.

Introducción. El cáncer colorrectal es un importante proble - ma de salud a nivel mundial debido a que es el tercer cáncer más frecuente y la tercera causa de mortalidad por cáncer en los países occidentales. El rastreo del cáncer colorrectal en pacientes asintomáticos es crucial para la reducción de su in - cidencia y la colonoscopía es uno de los métodos de elección. La capacidad de la colonoscopía en detectar lesiones pequeñas está claramente influenciada por la calidad de la preparación colónica. Objetivos. Conocer cuáles son las variables relativas al paciente y al tipo de preparación que afectan la calidad de la limpieza colónica. Materiales y métodos. Se diseñó un es - tudio de tipo corte transversal. A los sujetos enrolados se les ad - ministró un cuestionario para evaluar la presencia de factores que podrían afectar la calidad de la limpieza colónica. Luego fueron sometidos a una colonoscopía. Se compararon las dife - rentes variables entre los sujetos con adecuada o inadecuada limpieza colónica. Resultados. Fueron evaluados 277 sujetos. En el análisis multivariado las únicas variables que mostraron diferencia significativa son la toma dividida de la prepara - ción (split-dose) [OR 0,45 (0,1-0,99)] y la edad [OR 1,02 (1- 1,05)]. La obesidad no mostró diferencias significativas en el análisis multivariado [OR 1,84 (0,9-3,78)]. Conclusión. La edad y el split-dose fueron las únicas variables con asociación estadísticamente significativa con la calidad de la preparación colónica previa a una colonoscopía. No así la constipación ni la presencia de divertículos, por lo que estos pacientes no reque - rirían regímenes de preparación especiales.

BACKGROUND:Some previously published studies have suggested an inverse relationship between celiac disease and Helicobacter pylori, raising the possibility of the protective role Helicobacter pylori could have against celiac disease development. Nevertheless, this association is inconclusive.OBJECTIVES:To determine the prevalence of Helicobacter pylori infection in celiac subjects.METHODS:Between January 2013 and June 2014, patients over 18 years old undergoing upper endoscopy who required both gastric and duodenal biopsies were included for analysis. Enrolled subjects were divided in two groups: those with a diagnosis of celiac disease and those without a celiac disease diagnosis. Helicobacter pylori infection prevalence was compared between groups. Among celiac patients, endoscopic markers of villous atrophy as well as histological damage severity were compared between those with and without Helicobacter pylori infection.RESULTS:Overall, 312 patients were enrolled. Seventy two of them had a diagnosis of celiac disease. Helicobacter pylori infection prevalence among celiac disease patients was 12.5%, compared to 30% in non-celiac patients [OR=0.33 (0.15-0.71)]. There was not a significant difference in terms of the severity of villous atrophy in patients with Helicobacter pylori infection compared to those without it. There was a slight increase in the prevalence of endoscopic markers in those Helicobacter pylori-negative celiac subjects.CONCLUSION:Helicobacter pylori infection seems to be less frequent in celiac patients; among those celiac subjects with concomitant Helicobacter pylori infection, histological damage degree and presence of endoscopic markers suggesting villous atrophy seem to be similar to those without Helicobacter pylori infection.

Aim. To perform a measurement of the pH in nose, pharynx and esophagus in patients with combination of esophagitis and rhinosinusitis compared to control groups. Methods. Diagnosis of rhinosinusitis was carried out on the basis of international criteria (1). Diagnosis of esophagitis was carried out on the basis of the Los Angeles classification (2). 76 patients aged 18 to 62 years were randomized into 3 groups. Group A included 25 individuals with a combination of rhinosinusitis, heartburn and esophagitis; in group B were 29 patients with rhinosinusitis without heartburn and without esophagitis; in group C were 22 persons without rhinosinusitis and without GERD. For all patients were performed a 24-hour pH monitoring of the esophagus, pH-metry of the nose and pharynx. For all patients performed microbiological examination of discharge from the middle nasal passage. Results. The mean time with pH below 4 in the esophagus during 24 hour was equal to 25.4% in Group A, 23.8% in group B, and 5.2% in group C (OR1-3=6,20; CI=4,05-9,48; OR23=5,69; CI= 3,73-8,67). The pH of the nose in patients in groups A, B and C was similar. Middle pH in the pharynx in patients in group A was 4,7 ± 0,4; Group B 6,4 ± 0,6 (p1-2 <0,02); Group C 7,2 ± 0,6 (p1-3 <0,002). Microbiological examination revealed strains of S. Aureus, E. Coli, Candida albicans at 100% of patients in group A, 52% of people in group B (OR1-2=47,71; CI=2,65-857,6) and 23% in group C (OR13=162,27; CI=8,42-3126,21). Conclusion. The patients with a combination of rhinosinusitis and esophagitis observed decrease of pharyngeal pH and recorded more frequent seeding of pathological flora in the nasal mucosa in versus with persons without GERD. References: 1. Fokkens W.J., Lund V.J., Mullol J. et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl. 2012; 3(23): 1-298. 2. Lundell L.R., Dent J., Bennet J.R. Endoscopic assessment of oesophagitis clinical and functional correlates and further validation of Los Angeles classification. Gut. 1999; 45(2): 172-180.

Background: IBS pathophysiology remains poorly understood; however, recent findings support a state of immune activation characterized by increased TLR expression and intestinal epithelial diffusion of bacterial molecules in the gut, at least in a subgroup of patients.Aims: We sought to relate these factors in IBS, by analyzing the maturation phenotype of peripheral blood monocyte/macrophage cells, according to the intestinal maturation-process [M1: initial stage (CD11c+CD206-), M2: advanced maturation (CD11c-CD206+CX3CR1+)] when stimulated with E. coli-Lipopolysaccharides (LPS).Methods: 21 IBS-Rome II patients and 19 controls were studied in Mexico City.Isolated peripheral blood mononuclear cells (PBMCs) were cultured for 72 hours with and without E. Coli-LPS, and the polarization phenotype of monocytes/macrophages (CD14+) was investigated by flow cytometry.Also, levels of Transforming Growth Factor-beta 1 (TGF-β1), a M2 cell-derived cytokine involved in tissue healing, was investigated by enzyme-linked immunosorbent assay (ELISA), in culture's supernatant.The Mann-Whitney U-test was used, considering a p<0.05 as significant.Results: LPS-stimulated CD14+ cells displayed lower CD11c expression levels in both IBS patients and controls than in the unstimulated condition (8766±730.2vs 12920±949.2,p<0.001 and 8233±613.9vs 13750±743.3,p<0.001; respectively), but there were no differences between the IBS and controls.Also, M1 (CD11c+CD206-) unstimulated cells showed lower CD11c expression in IBS vs controls (11540±537.5 vs 13860±893.7,p=0.038); while a decrease in both IBS (11540±537.5 vs 7940±537.7,p<0.001) and controls (13860±893.7 vs 8091±574.5,p<0.001) was observed after LPS-stimulation.In addition the percentage of CD11c+CD206+CX3CR1+ cells was higher in IBS vs controls (9.5±1.5% vs 4.9±1.4%)without LPS stimulation.When comparing the unstimulated vs LPS-stimulated condition, the CX3CR1 expression level in M2-cells increased in controls but not in IBS (71.1±89.5 vs -151.7±31.1,p<0.001).Finally, no differences were observed in TGF-β1 levels of both IBS vs controls (3.77±0.39vs 3.61±0.14),even after stimulation with LPS (3.58±0.18vs 3.57±0.13).Conclusions: The data suggests that the initial phase of maturation of monocytes/ macrophages is faster in IBS vs controls.However, the absence of an increase in CX3CR1 expression in response to LPS in IBS, suggests an altered immnoregulatory response in patients with this disorder.Nevertheless, lack of differences in TGF-β1 between the IBS and controls supports the hypothesis that CD11c-CD206+ CX3CR1+ cells in IBS are not related to a healing response but to altered immunoregulatory functions in the presence of PAMPs.

Introducción. Los inhibidores de la bomba de protones po - drían influir en los resultados de estudios de hidrógeno en aire espirado realizados en sujetos con síndrome de intestino irritable. Esto se debería al favorecimiento de sobrecrecimien - to bacteriano intestinal. Objetivos. Comparar la prevalencia de alteraciones en el perfil fermentativo en sujetos con sín - drome de intestino irritable expuestos y no expuestos al trata - miento con inhibidores de la bomba de protones. Materiales y métodos. Se enrolaron sujetos con diagnóstico de síndrome de intestino irritable. Se les administró un cuestionario so - bre severidad sintomática y para determinar el consumo de inhibidores de la bomba de protones, la dosis y el tiempo de tratamiento. Se les realizó un test de hidrógeno en aire espi - rado con lactulosa. Se comparó la prevalencia de alteraciones en el perfil fermentativo (área bajo la curva de concentra - ción de hidrógeno excretado/tiempo), entre pacientes con y sin tratamiento con inhibidores de la bomba de protones. Se comparó a su vez la prevalencia de sobrecrecimiento bacte - riano. Resultados. Se enrolaron 225 pacientes. No se en - contraron diferencias significativas en cuanto a los perfiles fermentativos [área bajo la curva 3.776 (2.124 - 5.571) vs 4.347 (2.038 - 5.481), P = 0,3] como tampoco en la pre - valencia de sobrecrecimiento bacteriano de intestino delgado [33% vs 27,5%, P = 0,46]. Esta diferencia permaneció no significativa al ajustar según dosis y tiempo de tratamiento. Llamativamente, el score sintomático de los sujetos bajo tra - tamiento con inhibidores de la bomba de protones fue sig - nificativamente mayor [28,5 (23-26) vs 23 (15-29), P = 0,01]. Conclusión. Los inhibidores de la bomba de protones no inducen cambios significativos en los resultados del test de aire espirado, independientemente de la dosis y el tiempo de administración.

INTRODUCTION:Proton pump inhibitors could have an impact on the results of breath tests performed in patients with irritable bowel syndrome. This impact could be due to the development of small intestine bacterial overgrowth.OBJECTIVE:To compare the prevalence of fermentative profile alterations of irritable bowel syndrome patients exposed and not-exposed to proton pump inhibitor therapy.MATERIAL AND METHODS:Subjects with irritable bowel syndrome were enrolled. A validated questionnaire assessing symptom severity as well as proton pump inhibitor treatment was delivered. A lactulose breath test was undertaken by each enrolled subject. Fermentative profile (area under the curve of hydrogen excretion/time) was compared between proton pump inhibitors consumers and non-consumers. Furthermore, small intestine bacterial overgrowth prevalence was compared.RESULTS:Two hundred and twenty five patients were enrolled. No significant differences were found on the fermentative profile between groups [AUC mediana 3,776 (rango 2,124-5,571) vs 4,347 (rango 2,038-5,481), P = 0.3]. Small intestine bacterial overgrowth prevalence was similar as well [33% vs 27.5%]. These differences remained non-significant after adjusting for proton pump inhibitor dose and treatment time. Surprisingly, symptom score was significantly higher in those patients under proton pump inhibitor therapy [28.5 (23-26) vs 23 (15-29), P = 0.01].CONCLUSION:Proton pump inhibitors have no significant influence on lactulose breath tests, regardless of the dosage and time of administration.

AIM: Compare symptom occurrence and severity among IBS patients with an early vs. late increase in H2 excretion, as measured by LBT, and evaluate the association between symptom severity and global H2 global excretion. METHODS: Patients with an IBS diagnosis (Rome III criteria) as well as healthy subjects were enrolled consecutively. Subjects were asked to fill in a validated symptom-severity questionnaire (IBS-SSS) and to undergo a LBT. The area under the curve (AUC) was calculated for each LBT hydrogen/time curve. RESULTS: This analysis included 160 IBS and 45 healthy control subjects. An early increase in H2 excretion was observed in 53% of IBS subjects, and this was not significantly different from that observed in healthy subjects. There was also no significant difference in symptom pattern or severity between IBS patients with early vs. late increases in H2 excretion. However, a significant correlation between symptom severity and AUC value was observed (R2: 0.4, 95% CI: 0.1-0.6, p=0.02). CONCLUSION: Symptom pattern and severity was not significantly different among IBS patients with early vs. late increases in H2 excretion. However, the severity of IBS symptoms was significantly associated with global H2 excretion, as measured by the AUC.

Introducción. En sujetos con síndrome de intestino irritable (SII) existiría una alteración en el perfil fermentativo intestinal que contribuiría al desarrollo de sus síntomas. En un determinado grupo de pacientes se observa escasa producción de hidrógeno en el test de aire espirado y se los considera como portadores de una flora bacteriana con predominio de microorganismos consumidores de hidrógeno. Objetivo. El objetivo de este trabajo fue describir la frecuencia de presentación de estudios del hidrógeno en aire espirado en pacientes con SII en los que se encuentra baja producción del mismo y comparar el patrón catártico de éstos con respecto a aquellos con alta o normal producción de hidrógeno. Materiales y métodos. Se incluyeron pacientes con diagnóstico de SII a los que se les realizó un test de aire espirado con lactulosa y un cuestionario para determinar su patrón catártico. Se compararon las diferencias en dicho patrón entre pacientes con baja y alta producción de hidrógeno. Resultados. Se diseñó un estudio de tipo caso-control. Fueron incluidos 110 pacientes, de los cuales 15 (13,6%) presentaron resultados en test de aire espirado con bajos niveles de hidrógeno, compatible con predominio de microorganismos consumidores de hidrógeno. En el grupo de baja producción de hidrógeno, 11 pacientes (73,33%) refirieron ser estreñidos. En cambio, en el grupo de alta o normal producción de hidrógeno solo 30 pacientes (31,58 %) refirieron ser estreñidos [OR 5,95 (intervalo de confianza de 95% 1,75-20,25; P = 0,03)]. Conclusión. En pacientes con SII con baja producción de hidrógeno en el test de aire espirado con lactulosa existe una probabilidad 6 veces mayor de estreñimiento con respecto a aquellos pacientes con alta producción de hidrógeno.

use of contemporary ADs.These findings warrant prospective validation, but suggest that choice of AD agents for use in FGIDs might be better guided by other patient factors (i.e., depression, medical conditions, side-effects) rather than AD efficacy.

Existen evidencias que sugieren que la flora bacteriana intestinal cumpliría un rol en el desa - rrollo del síndrome de intestino irritable. Su actividad puede ser medida indirectamente mediante un test de hidrógeno en el aire espirado. Está demostrada la efica - cia del uso de antibióticos como la rifaximina o de pro - bióticos en el tratamiento de dicho síndrome. Nuestro propósito fue evaluar la eficacia del tratamiento secuen - cial con rifaximina/probiótico en pacientes con intesti - no irritable. Material y métodos. Fueron evaluados en forma prospectiva aquellos pacientes con diagnóstico de síndrome de intestino irritable de acuerdo con los criterios de Roma III. A los pacientes incluidos se les administró un cuestionario de auto-evaluación, el Irri - table Bowel Syndorme Severity Scale, para estimar la severidad de sus síntomas. Asimismo, se les practicó un test de hidrógeno en el aire espirado utilizando la lac - tulosa como sustrato. Con los resultados se confeccionó una curva de concentración de hidrógeno/tiempo y se calculó el valor del área bajo la curva. Posteriormente los pacientes recibieron tratamiento con rifaximina por siete días seguida de probióticos por diez días. Treinta días después del mismo se les administró nuevamente el mismo cuestionario y se les realizó un nuevo test del aire espirado. Resultados. Fueron incluidos 15 pacientes y el 93% presentó mejoría sintomática significativa. A su vez, la reducción de los valores del test de hidrógeno en aire espirado fue significativa, observándose en el 93% de los pacientes. Conclusión. El tratamiento secuen - cial rifaximina/probiótico sería eficaz para la mejoría sintomática y la disminución del perfil fermentativo en pacientes con intestino irritable.

INTRODUCTION:There is growing evidence that a disorder in intestinal microbiota would contribute to the development of symptoms in irritable bowel syndrome (IBS) patients. In a subgroup, a remarkably low hydrogen production in lactulose breath test (LBT) is observed. We presume in these patients a predominance of hydrogen consuming gut flora.OBJECTIVE:[corrected] Describe the clinical presentation of lBS patients with low hydrogen production and to compare their cathartic pattern against those with high hydrogen excretion.MATERIALS AND METHODS:A case-control study was designed. IBS outpatients were included. A validated questionnaire was delivered (IBSSS) in order to assess their symptoms and a LBT was performed. The cathartic pattern was compared between those with low and high hydrogen production on LBT.RESULTS:One hundred and ten patients were included and 15 of them (13.6%) had low hydrogen production on LBT, which would be compatible with the presence of hydrogen-consuming gut flora. In this group, 11 patients (73.33%) were constipated In contrast, only 30 patients (31.58%) in the high or normal hydrogen production group were constipated [OR 5.95 (95% confidence interval 1.75-20.25; P = 0.03)].CONCLUSION:IBS patients with low hydrogen production on lactulose breath test were 6 times more frequently constipated.

INTRODUCTION There is evidence suggesting that intestinal microbiota plays a role in the development of irritable bowel syndrome. Its activity can be indirectly assessed using the lactulose breath test. Antibiotics like rifaximin or probiotics can be used as therapeutic options for patients with irritable bowel syndrome. Our purpose was to evaluate the efficacy of a sequential treatment with rifaximin and probiotics in these patients. MATERIAL AND METHODS We prospectively evaluated patients with diagnosis of irritable bowel syndrome according to Rome III criteria. Included patients had to fill in a questionnaire in order to assess their symptoms severity. A lactulose breath test was also performed in each case and a curve with the results of hydrogen concentration and time was elaborated. Then, the area under the curve was calculated After initial evaluation, patients received a seven-day treatment with rifaximin, followed by a ten-day course of probiotics. Thirty days after completion of treatment a new lactulose breath test along with a questionnaire were performed. RESULTS We included 15 patients and 93% experienced a significant improvement of their symptoms as well as a significant reduction of the lactulose breath test values. CONCLUSION Sequential treatment with rifaximin/probiotics seems to be effective for symptom and fermentative profile improvement in irritable bowel syndrome patients.

UNLABELLED:INTRODUCTION. There are three indexes that correlate symptoms and reflux episodes in pHmetry tests. The utility of these indexes have been evaluated in prospective trials but their advantages and disadvantages remain controversial. OBJECTIVE:To assess the clinical utility of the pHmetric symptomatic correlation indexes in patients with pathological acid reflux. MATERIAL AND METHODS:A sequential pilot study of pHmetry tests was performed between September 2008 and June 2010. Twenty patients with gastroesophageal reflux and a DeMeester score above 14.5 were included. For the analysis, a distinction was made between strong acid reflux episodes (pH < 4) and weak acid reflux episodes (pH < 7 and > 4). The following indexes were calculated for both groups mentioned before: symptom index (SI), symptom sensitivity index (SSI) and symptom association probability (SAP). RESULTS:The mean age was 54 and 55% of patients were male. There were 116 symptomatic episodes (mean 5.8 per patient), 1,634 strong acid reflux episodes and 555 weak acid reflux episodes. Twelve (60%) had positive SI for strong acid reflux. Twelve had positive SSI for strong acid reflux and 91.66% of them had positive SI. Only 4 patients had a positive SAP. Only 2 patients had a positive SI for weak acid reflux and none of them had either a positive SI for strong acid reflux or a positive SAP for weak acid reflux. Finally, 30% of patients had a positive SSI for weak acid reflux. CONCLUSION:Positive correlation was significantly higher in strong acid rather than in weak acid reflux. SAP was the index with the lowest percentage of positivity. On the other hand, there was a high concordance between SI and SSI. Thus, the PAS index does not seem to have enough clinical utility in this cohort of patients.

Introduccion. Habitualmente los pacientes con sobrecrecimiento bacteriano del intestino son tratados con el empleo de diversos antibioticos. Actualmente existen evidencias de que determinados probioticos presentan efectividad en la respuesta clinica en pacientes con distension abdominal con o sin intestino irritable. Objetivos. Establecer la eficacia clinica comparativa a corto plazo del metronidazol vs un probiotico en pacientes con sobrecrecimiento bacteriano del intestino y distension abdominal cronica funcional. Pacientes y metodos. Se trata de un estudio piloto prospectivo y aleatorizado. Cincuenta pacientes con distension abdominal cronica (criterios de Roma III) y diagnostico de sobrecrecimiento bacteriano del intestino mediante test de lactulosa H2 en aire espirado (criterios de Pimentel y col) fueron aleatorizados (metodo computarizado) en forma consecutiva para recibir: 25 sujetos (23 mujeres, edad mediana: 49±19 anos) metronidazol, 500 mg dos veces por dia durante 5 dias, y 25 sujetos (20 mujeres, edad mediana 58±19 anos) un probiotico conteniendo Lactobacilus casei (3,3 X 10 7 UFC), Lactobacilus plantarum (3,3 X 10 7 UFC) Streptococcus faecalis (3,3 X 10 7 UFC) y Bifidobacterium brevis (1,0 X 10 6 UFC), 5 ml dos veces por dia durante 5 dias. Todos efectuaron por igual una dieta con restriccion de alcohol, legumbres, lacteos y verduras de hoja. La respuesta al tratamiento fue evaluada por un interrogador independiente a los 15 dias de terminado el tratamiento, mediante un cuestionario de respuesta global de 5 niveles (mucho mejor, mejor, igual, peor y mucho peor). Mejor y mucho mejor fueron consideradas respuestas positivas. Resultados. Trece (52%) de los sujetos que recibieron metronidazol y 20 (82%) de los que recibieron el probiotico refirieron mejoria. Se constataron diferencias estadisticamente significativas a favor del probiotico (P = 0,036). Todos los pacientes evaluados completaron el tratamiento propuesto si

INTRODUCTION:Some patients complain of digestive symptoms related to diary products intake. This intolerance could be associated with an intestinal bacterial overgrowth or an increased fermentative intestinal profile and not due to lactose malabsorption.OBJECTIVE:To estimate the prevalence of bacterial overgrowth in subjects with digestive symptoms related to diary products intolerance.MATERIAL AND METHODS:Patients who had performed hydrogen breath test due to chronic functional distension syndrome (Rome III) were analyzed. Thirty of them (22 female, average age 52 years) complained of symptoms related to diary products intake. All subjects completed a nutritional survey that allowed to assess the degree of tolerance to milk products and performed the hydrogen breath test with lactulose as substrate. Bacterial overgrowth was considered when baseline values were over 15 parts per million (ppm), values before 80 minutes were greater than 20 ppm or values of area under the curve were greater than 3,000 ppm/min in the 180 studied minutes.RESULTS:Fifty four patients were analyzed. Thirty of them showed moderate, important or severe clinical milk intolerance. Of these patients, 23 (77%), had a positive breath hydrogen test according to used criteria.CONCLUSIONS:The prevalence of small bowel bacterial overgrowth or an increased fermentative intestinal profile among individuals who complain of symptoms related to diary products is high and this fact should be considered in order to avoid empirical restrictive diets.