ORIGINAL ARTICLE Small Intestinal Bacterial Overgrowth and Orocecal Transit Time in Patients of Inflammatory Bowel Disease S. V. Rana • S. Sharma • A. Malik • J. Kaur • K. K. Prasad • S. K. Sinha • K. Singh Received: 23 September 2012 / Accepted: 18 April 2013 / Published online: 7 May 2013 Ó Springer Science+Business Media New York 2013 Abstract Background Inflammatory bowel disease (IBD) consists of Ulcerative colitis (UC) and Crohn’s disease (CD). These two conditions share many common features—diarrhea, bloody stools, weight loss, abdominal pain, fever and fatigue. Small intestinal bacterial overgrowth (SIBO) is frequent in patients with CD but it has not been studied in UC Indian patients. Aim The study was planned to measure orocecal transit time (OCTT) and SIBO in UC and CD patients. Methods One hundred thirty-seven patients of IBD (95 UC and 42 CD) and 115 healthy controls were enrolled. OCTT and SIBO were measured by lactulose and glucose hydrogen breath test respectively. Concentration of hydrogen and methane were measured by SC microlyser from Quintron, USA. Results Mean ± standard deviation (SD) of OCTT in patients of IBD was significantly higher as compared to controls. Furthermore, OCTT was significantly higher in CD patients as compared to UC patients. It was also observed that occurrence of SIBO was significantly higher in IBD patients as compared to controls. The occurrence of SIBO in CD (45.2 %) was significantly higher as compared to patients in UC (17.8 %) group. Percentage of methane positive IBD patients (2.9 %) was significantly lower as compared to methane positive controls (24.4 %). Conclusion OCTT was significantly delayed in IBD patients as compared to controls and in CD patients as compared to UC patients. OCTT was significantly higher in SIBO positive IBD patients as compared to SIBO negative patients. Thus, we can suggest that delayed OCTT would have been the cause of increased SIBO in these patients. Keywords Small intestinal bacterial overgrowth Á Orocecal transit time Á Ulcerative colitis Á Crohn’s disease Introduction Crohn’s disease (CD) and Ulcerative colitis (UC) as a group are referred to inflammatory bowel diseases (IBD). Inflammation in CD can occur anywhere in the gastroin- testinal tract with segmental inflammation localized most frequently in the terminal ileum or large intestine while UC affects only the large intestine and is usually limited to the mucosal layer [1]. These two conditions share many common features like diarrhea, bloody stools, weight loss, abdominal pain, fever and fatigue [2]. This complex situation results due to relationships between genetic, microbial and environmental factors which culminate in a sustained activation of the mucosal immune and S. V. Rana Á S. Sharma Á A. Malik Á J. Kaur Á K. K. Prasad Á S. K. Sinha Á K. Singh Department of Super Specialty Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India e-mail: sharma_pgi@hotmail.com A. Malik e-mail: aasthamalik16@yahoo.com J. Kaur e-mail: jaspreetkaur83@gmail.com K. K. Prasad e-mail: kaushalkp10@hotmail.com S. K. Sinha e-mail: sarojksinha@hotmail.com K. Singh e-mail: kartarsinghpgi@hotmail.com S. V. Rana (&) House No. 137, Sector 15 A, Chandigarh 160012, India e-mail: svrana25@hotmail.com 123 Dig Dis Sci (2013) 58:2594–2598 DOI 10.1007/s10620-013-2694-x