Nació en Buenos Aires el 11 de abril de 1946. Estudió en la Universidad de Buenos Aires (UBA), graduándose como médica con honores. Realizó su residencia en Clínica Médica en el Hospital Alvear y rotó en Gastroenterología en el Hospital Posadas, bajo la dirección del Dr. Marcelo Royer y luego del Dr. Pablo Mazure junto con el Dr. Luis Colombato.

Introduction. Irritable bowel syndrome (IBS) accounts for a significant deterioration in the quality of life of patients who suffer from it and is a common reason for consultation in gastroenterology. The treatment of this syndrome includes a wide variety of medications and recommendations based on different factors of its physiopathology. However, the results are usually variable and sometimes unsatisfactory for either the patient or the treating physician. The main objective of the present work is to describe the different treatments used by gastroenterologists in the management of IBS in Argentina. Materials and methods. Questionnaire of forty-seven questions, prepared by experts, distributed by medical associations of gastroenterology in Argentina and answered by specialists via Google Forms. Results. 304 responses, 157 from women (51.6%) and 147 from men (48.4%). The mean age was 44 and 49.9 years, respectively. 87.5% consider improvement of quality of life as the main goal of treatment. Regarding physiopathology of diarrhea variant irritable bowel syndrome (IBS-D), 49.5% considered emotional stress, while for constipation variant irritable bowel syndrome (IBS-C), 42.8% considered it multifactorial, with a predominance of slow colonic transit. No treatment option was rated as very effective by more than 50% of the respondents. Rifaximin was considered the most effective treatment in IBS-D, while polyethylene glycol was for IBS-C. Statistical significant differences were observed among gastroenterology subspecialties in the treatment of IBS-D with respect to the efficacy of diet, amitriptyline and antibiotics other than rifaximin, and regarding the effectiveness for bisacodyl/picosulfate and antibiotics in the treatment of IBS-C. Conclusion. The most common pathophysiological mechanism in IBS-D is stress. The vast majority of respondents consider that the main goal of treatment is the improvement of the quality of life, over symptomatic relief. None of the drugs is considered very effective in the treatment of the different IBS variants by at least 50% of those surveyed. Statistically significant differences were observed in the proportion of monthly consultations for IBS regarding to age and in the effectiveness considered for some treatments in relation to the subspecialty of physicians. The therapeutic approach to IBS by Argentine gastroenterologists is varied and somewhat heterogeneous, resulting in a still inappropriate management of this condition.

INTRODUCTION AND AIMS:Due to its different clinical manifestations, gastroesophageal reflux disease (GERD) requires diverse diagnostic and therapeutic interventions. The aim of the study was to evaluate the degree of agreement among Latin American specialists, with respect to the management of GERD.MATERIALS AND METHODS:A cross-sectional study was conducted through a survey with 42 statements (22 related to diagnosis and 20 to treatment) applied to 56 specialists from Latin America. There were 4 possible statement responses: in complete agreement, in partial agreement, in partial disagreement, and in complete disagreement. Reproducibility, level of agreement, and concordance were measured through the Kappa statistic.RESULTS:The response rate was 81% (47/56). General concordance was low, given that there was complete concordance in only 12 statements (28.6%). There was partial concordance in 22 statements (52.4%) and no concordance in 8 (19%). The following themes had the most disagreement: the performance of endoscopy before beginning treatment, the use of proton pump inhibitors (PPIs) in patients with extraesophageal symptoms and with no typical symptoms, and the combined use of PPIs and prokinetics.CONCLUSIONS:In the present study, we found that there was agreement among the Latin American specialists for the diagnosis and management of GERD in less than one-third of the recommendations considered standard. The low concordance could be related to the fact that the availability of diagnostic tools and medications, as well as the prevalence of GERD phenotypes, is different in each country.

Introducción: Existe una extensa heterogeneidad en los reportes de la prevalencia de enfermedad celíaca en el contexto de la anemia ferropénica. Objetivo: Determinar la prevalencia de enfermedad celíaca en pacientes con anemia ferropénica. Materiales y métodos: Pacientes adultos con anemia ferropénica fueron reclutados para realizarse una endoscopia digestiva alta con biopsia duodenal. Se reclutaron asimismo voluntarios sanos de la comunidad como controles. Resultados: Se reclutó a 135 pacientes con anemia y 133 controles. La prevalencia de enfermedad celíaca fue mayor en el grupo de anemia (11.11% vs. 1.51%, OR 8.18 [1.83-36.55], p = 0.001); el 73.3% de los celíacos en el grupo de anémicos presentaron algún signo endoscópico de atrofia vellositaria, mientras que el 100% de los celíacos en el grupo control presentaron por lo menos un signo endoscópico. Conclusión: Los pacientes con anemia ferropénica presentan un riesgo incrementado de enfermedad celíaca. Hasta un 25% de estos pacientes pueden no presentar signos endoscópicos indicativos de atrofia vellositaria.

Background: There is a wide heterogeneity in the reports of celiac disease prevalence in irondeficiency anemia patients. Aim: To determine the prevalence of celiac disease in patients with iron-deficiency anemia. Materials and methods: Adult patients with a diagnosis of iron-deficiency anemia were enrolled for upper endoscopy with duodenal biopsies. Healthy volunteers that underwent upper endoscopy were enrolled as controls. Results: A total of 135 patients with iron-deficiency anemia and 133 controls were enrolled. Celiac disease prevalence was higher in the iron-deficiency anemia group [11.11 vs. 1.51%, OR: 8.18 (1.83-36.55), P=.001). Of the celiac disease patients in the iron-deficiency anemia group, 73.3% had at least one endoscopic sign suggesting villous atrophy, whereas 100% of the celiac disease patients in the control group presented with at least one endoscopic sign. Conclusions: Patients with iron-deficiency anemia have an increased risk for celiac disease. Up to 25% of these patients may not present any endoscopic sign suggesting villous atrophy. (c) 2017 Asociacion Mexicana de Gastroenterologia. Published by Masson Doyma Mexico S.A. This is an open access article under the CC BY-NC-ND license.

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.

The chronic intestinal pseudoobstruction (CIPO) is a clini cal condition characterized by recurrent episodes of occlusion or partial bowel obstruction with...

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:In Argentina we have little access to the more sensitive and specific non-invasive diagnostic methods for the detection of Helicobacter pylori (HP), such as the urea breath test. The upper gastrointestinal videoendoscopy, with biopsy for histological analysis and rapid urease test remains as the usual method in our country, but the cost is high and the accessibility is also limited. For this reason we propose to develop a new fast, accurate, accessible and inexpensive method for measuring the concentration of expired NH in order to achieve a diagnosis of active infection.OBJECTIVE:To determine the utility of a non-invasive method for detecting HP through the measurement of ammonia in the breathing.MATERIALS AND METHODS:We studied 3 patients older than 21 years, attending the Gastroenterology clinic. All patients who meet the inclusion criteria were evaluated with an upper gastrointestinal videoendoscopy and gastric biopsies (antrum, body and incisura angularis). Samples were analyzed by histopathological examination and urease test. The subjects with both negative tests (non-infected) or positive (infected) were selected for ammonia measurement in exhaled air.RESULTS:The prevalence of HP infection was 60.9% (14 patients). Ten of these patients had significant differences between the baseline ammonia and the ammonia after urea ingestion, yielding a specifcity of 88.9% and a sensitivity of 71.43%, with a Jouden index higher than 50%.CONCLUSION:Although the experience must be carried forward, the results of this pilot study suggest that the measurement of ammonia in breath test after ingestion of unmarked urea would be applicable as a diagnostic test for HP, taking into account its low cost and easy management compared to conventional non-invasive methods.

Pancreatic intraductal papillary mucinous neoplasias (IPMN) are increasingly detected in medical diary practice because of increased awareness of their existence and because of increased use of cross-sectional imaging studies. IPMN are diagnosed incidentally in most cases and are classified as branch-duct IPMN, main-duct IPMN and combined-type IPMN. The last two types show a more aggressive biological behavior and surgery is recommended. Moreover, there are four subtypes of neoplastic epithelium in these tumours (intestinal, pancreatobiliary, gastric and oncocytic), which determine differences in the natural history of these neoplasms and this also seems to have prognostic relevance. We report a case of a patient who underwent a pancreatoduodenectomy due to a combined-type IPMN and whose anatomopathological study revealed an intestinal subtype IPMN with high grade dysplasia and colloid carcinoma. We also review the literature and describe the main aspects of this particular type ofcystic pancreatic tumours.

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:Untreated celiac disease has traditionally been linked to a greater risk for small intestinal bacterial overgrowth, but the existing evidence is inconclusive.AIMS:To compare the prevalence of small intestinal bacterial overgrowth in subjects with celiac disease compared with control subjects and patients with irritable bowel syndrome.MATERIAL AND METHODS:The study included 15 untreated celiac disease patients, 15 subjects with irritable bowel syndrome, and 15 healthy controls. All enrolled patients underwent a lactulose breath test measuring hydrogen and methane. Small intestinal bacterial overgrowth was defined according to previously published criteria.RESULTS:No differences were found in relation to age or sex. The prevalence of small intestinal bacterial overgrowth was similar between the celiac disease patients and the controls (20 vs. 13.33%, P=NS), whereas it was higher in patients with irritable bowel syndrome (66.66%, P<05).CONCLUSION:There was no difference in the prevalence of small intestinal bacterial overgrowth between the untreated celiac disease patients and healthy controls.

Introducción. En Argentina contamos con poca accesibilidad a los métodos diagnósticos no invasivos más sensibles y específicos para la detección de Helicobacter pylori (HP) como el test del aliento urea-C13. Por esto mismo proponemos el desarrollo de un nuevo método para la medición de la concentración de amoníaco (NH3) espirado con el fin de lograr un diagnóstico rápido, preciso, accesible y de bajo costo. Objetivo. Determinar la utilidad de un método no invasivo para la detección de HP, a través de la medición de NH3 en la respiración. Materiales y métodos. Se evaluaron 23 pacientes mayores de 21 años que acudieron al consultorio de Gastroenterología. A todos se les practicó videoendoscopía digestiva alta con biopsias gástricas (antro, cuerpo e incisura angular). Las muestras fueron remitidas para estudio histopatológico y prueba de ureasa. Los sujetos que tuvieron ambas pruebas negativas (no infectados) o positivas (infectados) fueron seleccionados para la medición del NH3 en aire espirado. Resultado. Se estableció una prevalencia de HP de 60,9% (14 pacientes). De éstos, 10 tuvieron diferencias significativas entre la medición de NH3 basal y posterior a la ingestión de urea, arrojando una especificidad de 88,9% y una sensibilidad de 71,43%, pero con un índice de Jouden mayor de 50%. Conclusión. Aunque se debe seguir desarrollando experiencia, los resultados de este estudio piloto sugieren que la medición de NH3 en el aire espirado tras la ingestión de urea no marcada sería aplicable como prueba diagnóstica de HP, teniendo en cuenta su bajo costo y simple manejo comparado con los métodos no invasivos tradicionales.

Background/Aims;In patients with gastric cancer, colorectal cancer is one of themost common synchronous cancers.Recently, preoperative colonoscopy for patients with gastric adenocarcinoma has been recommended. We aimed to assess the clinical value of colonoscopy by evaluating the frequency of colorectal neoplasm in patients with early gastric cancer(EGC) compared to healthy controls and analyzed the risk factors of advanced colorectal neoplasm in patients with EGC. Methods; The medical records of 203 patients who diagnosed as EGC and 201 healthy control matched sex and age were reviewed retrospectively. All of the subjects underwent colonoscopy for routine check-up. The frequency and clinical feature of the colorectal polyp were assessed and compared with control group. Risk factors of advanced colorectal neoplasm(high grade dysplasia, size ≥1cm, with villous component, carcinoma in situ and intramucosal cancer) in EGC were also analyzed. Results;Mean age of the patients was 61±10.3 years and 72.3% of the patients were male. The triglyceride level was significantly higher in EGC subgroup and BMI was higher in control group (P<0.05). The frequency of overall colorectal polyp was 62.6 % in the EGC group and 54.2% in the control group (p = 0.09). There was no significant difference in number of the polyps per patients between groups. However, the colorectal polyps in patients with EGC were located at right colon more frequently than in the control group(p<0.05). Advanced colorectal neoplasms were found in 10.3% of patients with EGC and 3% of controls (p <0.05). Colorectal cancers were found in 6 patients(4.6%) with EGC . By univariate analysis, patients with advanced colorectal neoplasm in EGC group were older than those with non-advanced neoplasm (66.9±12.4 vs 61.7±10.0, p=0.04). Multivariate analysis showed that the risk factors for advanced colorectal neoplasms in patients with EGC were old age and smoking. Conclusion: Although there was no significant difference in the frequency of overall colorectal polyp, the prevalence of coexisting advanced colorectal neoplasm was higher in patients with EGC than in normal population. Preoperative colonoscopy is strongly indicated in patients with EGC who are old age or smoker The present study showed that colonoscopy

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.