Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: I am grateful to Dr King for his
clarifications regarding my recent review on IBS. I agree that the lactulose
breath test provides an indirect demonstration of SIBO and that measurement
of breath hydrogen alone is inadequate. Currently, direct confirmation of
SIBO is severely limited by difficult access to the full length of the small
intestine and inadequate culturing and identification methods for the vast
majority of the more than 500 species of bacteria in the gut.
Lin HC. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome—Reply. JAMA. 2004;292(18):2213-2214. doi:10.1001/jama.292.18.2213-b