Diagnosis of Bacterial Overgrowth Syndrome and Lactase Deficiency in Patients with Irritable Bowel Syndrome in Practice of a Family Doctor

The objective: improving the quality of the diagnosis of irritable bowel syndrome, taking into account the state of intestinal microbiota and lactase deficiency by scientific and practical explanation of hydrogen breath tests using in the routine practice of the family doctor.Materials and methods. 150 patients with IBS were examined. In 32 patients with IBS, hydrogen tests with lactulose and glucose were used. Tests were performed using Advanced Hydrogen Breath Testing (Micro H2 Meter). In order to investigate the diagnostic value of lactose respiratory test (LRT), a biochemical study of lactase activity in the biopsy of the postbulbary department of the duodenum was selected as a comparison method. 30 persons (15 men, 15 women) with irritable bowel syndrome and anamnestically suspected lactase deficiency (LD) were examined.Results. The irritable bowel syndrome was more common in women (67,3%), the ratio of women and men among these patients was 2:1. From the different forms of IBS, the variant of IBS-C was prevalent in 69 (46,0%) patients, patients with IBS-D were 32 (21.3%), and persons with IBS-M were 49 (32,7%). In patients with IBS bacterial overgrowth syndrome was found in 37,5% of cases. Sensitivity, specificity of the glucose respiratory test was detected: the sensitivity was 83,3%, the specificity was 84,9%. Sensitivity, specificity of the lactose respiratory test was detected: the sensitivity is 85,7%, the specificity is 81,3%. Reduced lactase activity was found in 50% of patients with IBS.Conclusions. In patients with irritable bowel syndrome, for the diagnosis of bacterial overgrowth syndrome and lactase deficiency, it is advisable to use hydrogen glucose and lactulose respiratory tests, alone or in combination, which increases the reliability of the results of the diagnosis. They are non-invasive, highly informative and correlate with microbiological methods.