Interrelation Between Helicobacter Pylori, Methanogens, Food, and Functional Dyspeptic Syndromes

The microbe-host interaction in the intestinal tract underlies many human disorders, including disorders of gut-brain interactions, previously termed functional bowel disorders, such as Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO). 1.1. Objective: To determine whether Helicobacter pylori infection is associated with irritable bowel syndrome, small bowel bacterial overgrowth, and other functional gut disorders. 1.2. Design: Case-control retrospective study at local tertiary hospitals in Egypt. 1.3. Methods: A total of 125 cases of IBS that met Rome IV criteria, 100 cases with SIBO, and 100 controls (IBS and SIBO-negative), aged 18 to 60 years old, were involved in this study. Patients were recruited from August 2023 to July 2024, and matched by age, sex, and other demographic variables. All participants were tested for urea breath test, lactulose hydrogen‐methane breath test, and H pylori stool antigen tests. 1.4. Results: Of the total 225 cases, 125 (55.6%) had reported IBS, a 100 (44.4%) had SIBO, compared to 100 in the control group. H. pylori was present in 109 (48.4%) of cases compared to only 16 (16.0%) in the control group. Highly significant differences between IBS cases and controls regarding UBT and H P stool antigen test positivity were observed (P< 0.0001). There are significant differences between SIBO cases, and control regarding constipation, methane test positivity, hydrogen test positivity, and body mass index (P< 0.0001, < 0.0001, 0.023, and 0.045 respectively). There was a significant difference in stool antigen test positivity between SIBO and IBS, meaning that SIBO cases have more HP stool positivity than IBS cases. The production of methane in SIBO cases is higher and more significant than hydrogen production (P< 0.0001, P= 0.023 respectively). 1.5. Conclusion: Our study provides a new correlation between IBS, SIBO, and H. pylori infection. Moreover, while the relationship between H pylori and IBS is well known, our novel findings include; The correlation between H. pylori, IBS, and SIBO. The correlation between SIBO and methane production. SIBO cases have more HP stool positivity than IBS cases. Based on the evidence presented herein linking urease to the pathogenesis of various functional gut disorders, we could inspire researchers to develop a new anti-urease treatment for functional gut disorders in the future.