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Small intestinal bacterial overgrowth
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== Comorbidities == Anecdotal reports suggest a high prevalence of SIBO among CFS patients.{{Citation needed| date = July 2022}} One study of 24 CFS patients found 77% had SIBO, however it found no difference between the blinded treatment arms after treatment with neomycin, an antibiotic. Including patients with both open label and blinded treatment, it did find that those that had eradication improved compared to their baseline scores.<ref name="Pimentel2000">{{Cite journal | last1 = Pimentel | first1 = M | authorlink1 = Mark Pimentel | last2 = Hallegua | first2 = D | authorlink2 = David Hallegua | last3 = Chow | first3 = EJ | authorlink3 = | last4 = Wallace | first4 = D | authorlink4 = Daniel Wallace | last5 = Bonorris | first5 = G | authorlink5 = | last6 = Lin | first6 = HC | authorlink6 = Henry Lin | title = Eradication of small intestinal bacterial overgrowth decreases symptoms in chronic fatigue syndrome: A double blind, randomized study | journal = Gastroenterology | volume = 118 | issue = 4| pages = 414 | date = Apr 1, 2000 | doi = 10.1016/S0016-5085(00)83765-8| url = http://www.gastrojournal.org/article/S0016508500837658/abstract }}</ref> Research has found patients with CFS have alterations in microbiota, including lower levels of bifidobacteria and SIBO.<ref name="Logan2003">{{Cite journal | last1 = Logan | first1 = Alan C | last2 = Venket Rao | first2 = A | last3 = Irani | first3 = Dinaz | title = Chronic fatigue syndrome: lactic acid bacteria may be of therapeutic value | journal = Medical Hypotheses | volume = 60 | issue = 6 | pages = 915β923 | date = Jun 2003 | pmid = 12699726| url = http://www.ncbi.nlm.nih.gov/pubmed/12699726 }}</ref> Several studies have shown that up to 84% of patients with [[irritable bowel syndrome]] have SIBO<ref name="Dukowicz2007" /> and that symptoms improve after treatment<ref name="Pimentel2004">{{Cite journal | last1 = Pimentel | first1 = M | authorlink1 = Mark Pimentel | last2 = Wallace | first2 = D | authorlink2 = Daniel Wallace | last3 = Hallegua | first3 = D | authorlink3 = David Hallegua | last4 = Chow | first4 = EJ | authorlink4 = Evelyn Chow | last5 = Kong | first5 = Y | authorlink5 = Y Kong | last6 = Park | first6 = S | authorlink6 = S Park | last7 = Lin | first7 = HC | authorlink7 = Henry Lin | title = A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing | journal = Annals of the Rheumatic Diseases | volume = 63 | issue = 4 | pages = 450β452 | date = Apr 2004 | pmid = 15020342 | doi = 10.1136/ard.2003.011502 | url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754959/ }}</ref><ref name="LinHC2004">{{Cite journal | last1 = Lin | first1 = HC | authorlink1 = Henry Lin | title = Small intestinal bacterial overgrowth: A framework for understanding irritable bowel syndrome | journal = JAMA | volume = 292 | issue = 7| pages = 852β858 | date = Aug 18, 2004 | doi = 10.1001/jama.292.7.852 | url = http://jama.jamanetwork.com/article.aspx?articleid=199251 }}</ref>, while others fail to replicate these results.<ref name="Walters2005">{{Cite journal | last1 = Walters | first1 = B | authorlink1 = B Walters | last2 = Vanner | first2 = SJ | authorlink2 = S J Vanner | title = Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-D-xylose and healthy controls | journal = The American Journal of Gastroenterology | volume = 100 | issue = 7| pages = 1566β1570 | date = Jul 2005 | pmid = 15984983 | doi = 10.1111/j.1572-0241.2005.40795.x | url = http://www.ncbi.nlm.nih.gov/pubmed/15984983 }}</ref><ref name="Parisi2003">{{Cite journal | last1 = Parisi | first1 = Giancarlo | last2 = Leandro | first2 = Gioacchino | last3 = Bottona | first3 = E | last4 = Carrara | first4 = M | last5 = Cardin | first5 = F | last6 = Faedo | first6 = A | last7 = Goldin | first7 = D | last8 = Pantalena | first8 = M | last9 = Tafner | first9 = G | last10 = Verdianelli | first10 = G | last11 = Zilli | first11 = M | last12 = AISGE Group | title = Small intestinal bacterial overgrowth and irritable bowel syndrome | journal = The American Journal of Gastroenterology | volume = 98 | issue = 11 | pages = 2572-2574 | date = Nov 2003 | pmid = 14638371 | doi = 10.1111/j.1572-0241.2003.08686.x | url = http://www.ncbi.nlm.nih.gov/pubmed/15984983 }}</ref> One study found that a 100% of [[fibromyalgia]] patients tested positive to a lactulose breath test, indicating SIBO, and that the degree of abnormality on the breath test correlated with the amount of pain reported.<ref name="Pimentel2004" />
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