Accuracy of glucose breath testing for small intestine bacterial overgrowth (SIBO) using endoscopy aspirate cultures as a reference standard: A meta-analysis
A meta-analysis presented at the 2019 American College of Gastroenterology meeting shows significant limitations to current diagnostic methods for small intestine bacterial overgrowth (SIBO).
Current methods for sampling the gut make it difficult for healthcare providers to accurately diagnose and monitor gastrointestinal diseases. In this study, a meta-analysis of eleven studies with data on patients tested with both a glucose breath test and endoscopy aspirate culture was performed. Fixed-effects and random-effects models were fit to the studies’ data, and the mean positive and negative percent agreement across studies was estimated with both models.
What did we find?
Breath testing is not standardized; differences in dose of the substrate and duration of the breath test were observed.
Endoscopy aspirate culture is not standardized; the amount of liquid collected, the site of collection, and the technical details of the microbiological tests may differ.
The random effects model estimates of 54% positive agreement and 76% negative agreement indicate moderate to poor agreement between breath testing and endoscopy aspirate culture.
SIBO is under-diagnosed and there are significant limitations with currently available testing methods.1
Poster presented at the American College of Gastroenterology Annual Scientific Meeting, October 25–30, 2019
References
- Stylli J, Lee SN, Kelly C, et al. Accuracy of glucose breath testing for SIBO using endoscopy aspirate cultures as a reference standard: A meta-analysis. Poster presented at ACG, 2019. San Antonio, Texas.