Scholarlink

Background <p>Irritable bowel syndrome (IBS) is a common disorder with multi-factorial pathophysiology. Emerging evidence suggests a role of low-grade mucosal inflammation in IBS. Small intestinal bacterial overgrowth (SIBO), which has symptoms similar to IBS, may be misdiagnosed as IBS. Data on the prevalence of SIBO and elevated fecal calprotectin (FCP) levels in IBS patients remains sparse and conflicting. We aimed at determining the prevalence and clinical significance of SIBO and elevated FCP in patients with refractory IBS.</p> Methods <p>This prospective cross-sectional study enrolled refractory IBS patients (Rome-IV criteria). SIBO was diagnosed using the glucose&#xa0;hydrogen breath test and FCP levels ≥ 50 μg/g were considered elevated. Clinical evaluation was performed using standardized&#xa0;questionnaires: IBS Symptom Severity Scale (IBS-SSS) and IBS Quality of Life (IBS-QoL).</p> Results <p>&#xa0;Of 209 patients screened, 148 with refractory IBS were enrolled (mean age 35.8 ± 11.9&#xa0;years; 66.1% male). SIBO was detected in 46 (31.1%) and elevated FCP in 41 (27.7%) patients, with the highest prevalence in the IBS-D group (37.1% and 33.3%, respectively). Patients who were SIBO and/or FCP-positive had a longer duration of symptoms, higher IBS symptom burden and poorer QoL. Multi-variate analysis identified bloating (aOR = 4.59) and the IBS-SSS (aOR = 1.20) as independent predictors of SIBO.</p> Conclusions <p>Approximately one-third of patients with refractory IBS, particularly those with IBS-D, have SIBO and/or elevated FCP. This subset&#xa0;of patients demonstrates a higher symptom burden and poorer QoL, emphasizing the crucial need for accurate diagnosis and&#xa0;personalized treatment. Incorporating non-invasive biomarkers (SIBO testing and FCP) into the management of refractory IBS may&#xa0;optimize patient care.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prevalence, clinical significance and predictors of small intestinal bacterial overgrowth and elevated fecal calprotectin in refractory irritable bowel syndrome: Insights from a prospective cross-sectional study

  • 期刊论文

  • 发表日期：

    2026年4月29日

查看全文
  • Omesh Goyal,
  • Akash Aggarwal,
  • Manjeet Kumar Goyal,
  • Varun Mehta,
  • Ramit Mahajan,
  • Yogesh Gupta,
  • Arshdeep Singh,
  • Ajit Sood

摘要

Background

Irritable bowel syndrome (IBS) is a common disorder with multi-factorial pathophysiology. Emerging evidence suggests a role of low-grade mucosal inflammation in IBS. Small intestinal bacterial overgrowth (SIBO), which has symptoms similar to IBS, may be misdiagnosed as IBS. Data on the prevalence of SIBO and elevated fecal calprotectin (FCP) levels in IBS patients remains sparse and conflicting. We aimed at determining the prevalence and clinical significance of SIBO and elevated FCP in patients with refractory IBS.

Methods

This prospective cross-sectional study enrolled refractory IBS patients (Rome-IV criteria). SIBO was diagnosed using the glucose hydrogen breath test and FCP levels ≥ 50 μg/g were considered elevated. Clinical evaluation was performed using standardized questionnaires: IBS Symptom Severity Scale (IBS-SSS) and IBS Quality of Life (IBS-QoL).

Results

 Of 209 patients screened, 148 with refractory IBS were enrolled (mean age 35.8 ± 11.9 years; 66.1% male). SIBO was detected in 46 (31.1%) and elevated FCP in 41 (27.7%) patients, with the highest prevalence in the IBS-D group (37.1% and 33.3%, respectively). Patients who were SIBO and/or FCP-positive had a longer duration of symptoms, higher IBS symptom burden and poorer QoL. Multi-variate analysis identified bloating (aOR = 4.59) and the IBS-SSS (aOR = 1.20) as independent predictors of SIBO.

Conclusions

Approximately one-third of patients with refractory IBS, particularly those with IBS-D, have SIBO and/or elevated FCP. This subset of patients demonstrates a higher symptom burden and poorer QoL, emphasizing the crucial need for accurate diagnosis and personalized treatment. Incorporating non-invasive biomarkers (SIBO testing and FCP) into the management of refractory IBS may optimize patient care.

Graphical Abstract