429 Breath Testing Post Gastrointestinal Surgery

Abstract Introduction Breath test (BT) screening for small intestinal bacterial overgrowth (SIBO) post gastrointestinal surgery (GIS) are complex cases which unlock other clinical conditions in practice. This study addresses this topic. Method BTs were performed in accordance to Bedfont Scientific guidelines (20g Lactulose was used and Gastrolyzer analysed the breath samples). Patient undergoing BT post GIS between January to June 2025 were reviewed. Results 41 patients (15.1%) post GIS had BT (female:male=30:11, age 27-79 years) (see table 1 for surgery type and BT outcomes). The screening process detected prevalence of MA (MA)(29.3%) and suspected slow gut transit (SGT) from absence of colonic fermentation (43.9%).NSIBO1MA2Suspected SGT3Cholecystectomy1414.3%14.3%21.4%Colectomy1030.0%10.0%40.0%Appendectomy922.2%33.3%33.3%Bariatric Surgery40.0%50.0%50.0%Oesophageal Surgery1020.0%50.0%50.0%Small bowel surgery520.0%20.0%20.0% SIBO, Small Intestinal Bacterial Overgrowth;MA, Methanogenic Archaea;SGT, Suspected Gut Transit;N–number of cases for each surgery;11 patients had two types of surgery. All other patients had one type of surgery Diagnostic criteria 1SIBO diagnosed based of excessive hydrogen production from baseline level (≥20PPM)2MA diagnosed from evidence of excessive methane levels (≥10PPM)3SGT suspected from no excessive hydrogen production from baseline by 180-minutes (<20PPM) Table 1, shows prevalence of SIBO, MA and ACF for specific general surgery cases Conclusions More than half of the patients with GIS had symptoms arising from other clinical conditions than SIBO, which require alternative management.