Does Small Intestinal Bacterial Overgrowth Contribute to Functional Dyspepsia
Does Small Intestinal Bacterial Overgrowth Contribute to Functional Dyspepsia
The prevalence of functional dyspepsia (FD) is estimated to be 15% of the adult population.
 FD is commonly described as a condition of chronic abdominal discomfort localized to the
 upper abdomen. Postprandial bloating, pain, nausea, vomiting, belching, and early satiety are
 common symptoms of the FD patient. FD is defined by >12 weeks of symptoms, which need not be
 consecutive, within the preceding year consisting of a) persistent or recurrent dyspepsia and
 b) an absence of organic disease after a gastrointestinal endoscopy or x-ray series. FD is
 therefore considered a disorder of function because no mucosal pathology is seen in these
 patients, as in patients with other functional disorders such as irritable bowel syndrome
 (IBS) and fibromyalgia (FM). There is a remarkable degree of overlap among these three
 disorders. These 3 disorders share the finding of hypersensitivity and the symptom of
 postprandial bloating to suggest the possibility of a common origin.
Inclusion Criteria:

 -  Must have FD based on the most recent Umbrella criteria of one or more of: a.
 bothersome postprandial fullness, b. early satiation, c. epigastric pain, d.
 epigastric burning

 -  No evidence of organic disease (including H. pylori detected at time of endoscopy)
 that is likely to explain the symptoms

 -  Criteria must be fulfilled for the last 3 months with symptom onset at least 6 months
 before the diagnosis

 -  The physical exam, routine blood tests including CBC, chemistry panel and liver tests,
 upper gastrointestinal endoscopy and 24h pH study must be normal

 Exclusion Criteria:

 -  History of IBS,rheumatoid arthritis,H. Pylori infection,lupus,peptic ulcer,
 cirrhosis,diabetes, HIV or TB

 -  Inflammatory bowel disease

 -  Bowel Resection (including gastric, small bowel or colon; gallbladder surgery or
 appendectomy are NOT exclusion criteria)

 -  Anti/pro-biotics last 3 months

 -  Previous LBT (Lactulose Breath Test)

 -  Narcotic Dependence

 -  Pregnancy

 -  Control subjects will be excluded if they have symptoms of heartburn, retrosternal
 chest pain, chronic cough, nausea or regurgitation suggestive of gastroesophageal
 reflux disease