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Evaluating the accuracy and reproducibility of ChatGPT-4 in answering patient questions related to small intestinal bacterial overgrowth

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Artificial Intelligence in Gastroenterology 2024年第1期5卷 14-21页

作者： Lauren Schlussel Jamil S Samaan Yin Chan Bianca Chang Yee Hui Yeo Wee Han Ng Ali Rezaie Division of Gastroenterology and Hepatology Cedars-Sinai Medical CenterLos AngelesCA 90048United States Bristol Medical School University of BristolBS81THBristolUnited Kingdom Medically Associated Science and Technology Program Cedars-Sinai Medical CenterLos AngelesCA 90048United States

BACKGROUND small intestinal bacterial overgrowth(SIBO)poses diagnostic and treatment challenges due to its complex management and evolving *** often seek online information related to their health,prompting interest in large language models,like GPT-4,as potential sources of patient *** To investigate ChatGPT-4's accuracy and reproducibility in responding to patient questions related to *** A total of 27 patient questions related to SIBO were curated from professional societies,Facebook groups,and Reddit *** question was entered into GPT-4 twice on separate days to examine reproducibility of accuracy on separate ***-4 generated responses were independently evaluated for accuracy and reproducibility by two motility fellowship-trained gastroenterologists.A third senior fellowship-trained gastroenterologist resolved *** of responses were graded using the scale:(1)Comprehensive;(2)Correct but inadequate;(3)Some correct and some incorrect;or(4)Completely *** responses were generated for every question to evaluate reproducibility in *** In evaluating GPT-4's effectiveness at answering SIBO-related questions,it provided responses with correct information to 18/27(66.7%)of questions,with 16/27(59.3%)of responses graded as comprehensive and 2/27(7.4%)responses graded as correct but *** model provided responses with incorrect information to 9/27(33.3%)of questions,with 4/27(14.8%)of responses graded as completely incorrect and 5/27(18.5%)of responses graded as mixed correct and incorrect *** varied by question category,with questions related to“basic knowledge”achieving the highest proportion of comprehensive responses(90%)and no incorrect *** the other hand,the“treatment”related questions yielded the lowest proportion of comprehensive responses(33.3%)and highest percent of completely incorrect responses(33.3%).A total of 77.8%of questions yielded repr

关键词： small intestinal bacterial overgrowth Motility Artificial intelligence Chat-GPT Large language models Patient education

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Assessment of small intestinal bacterial overgrowth in uncomplicated acute diverticulitis of the colon

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World Journal of Gastroenterology 2005年第18期11卷 2773-2776页

作者： Antonio Tursi Giovanni Brandimarte Gian Marco Giorgetti Walter Elisei Digestive Endoscopy Unit "Lorenzo Bonomo" Hospital Andria Italy Department of Internal Medicine Division of Gastroenterology "Cristo Re" Hospital Rome Italy Clinical Nutrition Unit "S. Eugenio" Hospital Rome Italy

AIM: small intestinal bacterial overgrowth (SIBO) maycontribute to the appearance of several gastrointestinal nonspecific symptoms. Acute diverticulitis is affected by some similar symptoms and bacterial colonic overgrowth. We assessed the prevalence of SIBO in acute uncomplicated diverticulitis and evaluated its influence on the clinical course of the ***: We studied 90 consecutive patients (39 males, 51 females, mean age 67.2 years, range 32-91 years). Sixty-one patients (67.78%) and 29 patients (32.22%) were affected by constipation-or diarrhea-prevalent diverticulitis respectively. All subjects were investigated by lactulose H2-breath test at the entry and at the end of treatment. We also studied a control group of 20 healthy subjects (13 males, 7 females, mean age 53 years, range 22-71 years).RESULTS: Oro-cecal transit time (OCTT) was delayed in67/90 patients (74.44%) (range 115-210 min, mean 120 min). Fifty-three of ninety patients (58.88%) showed SIBO, while OCTT was normal in 23/90 patients (25, 56%). In the control group, the mean OCTT was 88.2 min (range 75-135 min). The difference between diverticulitic patients and healthy subjects was statistically significant (P＜0.01). OCTT was longer in constipation-prevalent disease than in diarrheaprevalent disease [180.7 min (range 150-210 min) vs 121 min (range 75-180 min) (P＜0.001)], but no difference in bacterial overgrowth was found between the two forms of *** treatment with rifaximin plus mesalazine for 10 d, followed by mesalazine alone for 8 wk, 70 patients (81.49%) were completely asymptomatic, while 16 patients (18.60%) showed only slight symptoms. Two patients (2.22%) had recurrence of diverticulitis, and two other patients (2.22%) were withdrawn from the study due to side-effects. Seventy-nine of eighty-six patients (91.86%) showed normal OCTT (range 75-105 min, mean 83 min), while OCTT was longer, but it was shorter in the remaining seven (8.14%) patients (range 105-115 min

关键词： small intestinal bacterial overgrowth Oro-oecal transit time

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Helicobacter pylori infection and small intestinal bacterial overgrowth–more than what meets the eye

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World Journal of Clinical Cases 2022年第21期10卷 7209-7214页

作者： Murali Dharan David Wozny Department of Gastroenterology and Hepatology University of Connecticut Health CenterFarmingtonCT 06030United States Department of Primary Care and Internal Medicine University of ConnecticutFarmingtonCT 06030United States

Helicobacter pylori(***)infection is very common and affects a significant proportion of the world *** contrast,the prevalence of small intestinal bacterial overgrowth(SIBO)in the general population is not well *** can be coexistence of both disease states in a given patient and their clinical symptoms may also overlap with one and *** is no clear clinical guidelines for testing for and treating SIBO in patients with *** *** review article explores the available evidence on the relationship between *** infection and SIBO,diagnosis and treatment of these entities and also comments on associated non-gastrointestinal conditions.

关键词： Helicobacter pylori infection small intestinal bacterial overgrowth Overlap Diagnosis Treatment

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Subclinical atherosclerosis is linked to small intestinal bacterial overgrowth via vitamin K2-dependent mechanisms

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World Journal of Gastroenterology 2017年第7期23卷 1241-1249页

作者： Francesca Romana Ponziani Maurizio Pompili Enrico Di Stasio Maria Assunta Zocco Antonio Gasbarrini Roberto Flore Internal Medicine Gastroenterology and HepatologyAgostino Gemelli Hospital Biochemistry Agostino Gemelli Hospital Internal Medicine and Vascular Medicine Agostino Gemelli Hospital

To assess the rate of matrix Gla-protein carboxylation in patients with small intestinal bacterial overgrowth (SIBO) and to decipher its association with subclinical *** with suspected SIBO who presented with a low risk for cardiovascular disease and showed no evidence of atherosclerotic plaques were included in the study. A glucose breath test was performed in order to confirm the diagnosis of SIBO and vascular assessment was carried out by ultrasound examination. Plasma levels of the inactive form of MGP (dephosphorylated-uncarboxylated matrix Gla-protein) were quantified by ELISA and vitamin K2 intake was estimated using a food frequency ***-nine patients were included in the study. SIBO was confirmed in 12/39 (30.8%) patients who also presented with a higher concentration of dephosphorylated-uncarboxylated matrix Gla-protein (9.5 μg/L vs 4.2 μg/L; P = 0.004). Arterial stiffness was elevated in the SIBO group (pulse-wave velocity 10.25 m/s vs 7.68 m/s; P = 0.002) and this phenomenon was observed to correlate linearly with the levels of dephosphorylated-uncarboxylated matrix Gla-protein (β = 0.220, R2 = 0.366, P = 0.03). Carotid intima-media thickness and arterial calcifications were not observed to be significantly elevated as compared to *** is associated with reduced matrix Gla-protein activation as well as arterial stiffening. Both these observations are regarded as important indicators of subclinical atherosclerosis. Hence, screening for SIBO, intestinal decontamination and supplementation with vitamin K2 has the potential to be incorporated into clinical practice as additional preventive measures.

关键词： small intestinal bacterial overgrowth Vitamin K Dysbiosis Atherosclerosis Cardiovascular disease risk

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Gut dysbiosis and small intestinal bacterial overgrowth as independent forms of gut microbiota disorders in cirrhosis

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World Journal of Gastroenterology 2022年第10期28卷 1067-1077页

作者： Roman Maslennikov Vladimir Ivashkin Irina Efremova Elena Poluektova Anna Kudryavtseva George Krasnov Department of Internal Medicine Gastroenterology and HepatologySechenov UniversityMoscow 119435Russia Scientific Community for Human Microbiome Research Moscow 119435Russia Department of Internal Medicine 1 Сonsultative and Diagnostic Center 2 of the Moscow City Health DepartmentMoscow 107564Russia Laboratory of Postgenomic Research Engelhardt Institute of Molecular BiologyRussian Academy of SciencesMoscow 119991Russia

BACKGROUND Gut dysbiosis and small intestinal bacterial overgrowth(SIBO)are commonly observed in patients with *** the substantial number of articles describing the relations between disorders of gut microbiota and various manifestations of cirrhosis,dysbiosis and SIBO were always studied *** To study the relationship of gut dysbiosis and SIBO in *** This observational study included 47 in-patients with *** microbiome was assessed using 16 S r RNA gene *** was assessed using the lactulose hydrogen breath *** SIBO was found in 24/47(51.1%)*** with SIBO had a higher abundance of Firmicutes(P=0.017)and Fusobacteria(P=0.011),and a lower abundance of Bacteroidetes(P=0.013)than patients without *** increase in the abundance of Firmicutes occurred mainly due to an increase in the abundance of bacteria from the genus Blautia(P=0.020)of the Lachnospiraceae family(P=0.047),while the abundance of other major families of this phylum[Ruminococcaceae(P=0.856),Peptostreptococcaceae(P=0.066),Clostridiaceae(P=0.463),Eubacteriaceae(P=0.463),Lactobacillaceae(P=0.413),and Veillonellaceae(P=0.632)]did not differ significantly between the patients with and without *** level of Bacteroidetes in samples from patients with SIBO was a result of the decrease in bacterial numbers from all the major families of this phylum[Bacteroidaceae(P=0.014),Porphyromonadaceae(P=0.002),and Rikenellaceae(P=0.047)],with the exception of Prevotellaceae(P=0.941).There were no significant differences in the abundance of taxa that were the main biomarkers of cirrhosis-associated gut dysbiosis[Proteobacteria(P=0.790),Bacilli(P=0.573),Enterobacteriaceae(P=0.632),Streptococcaceae(P=0.170),Staphylococcaceae(P=0.450),and Enterococcaceae(P=0.873)]between patients with and without *** Despite the differences observed in the gut microbiome between patients with and without SIBO,gut dysbiosis and SIBO are most

关键词： Dysbiosis Gut-liver axis Microbiome small intestinal bacterial overgrowth Cirrhosis Microbiota

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Progress in Diagnosis and Treatment of small intestinal bacterial overgrowth

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Journal of Biosciences and Medicines 2023年第8期11卷 35-43页

作者： Guangyang Zheng Di Yang Peilong Wang Yiqiang Zhang Lei Huang First Clinical College Changzhi Medical College Changzhi China Department of Endoscopy Heji Hospital Affiliated of Changzhi Medical College Changzhi China

small intestinal bacterial overgrowth has been found to be associated with a variety of gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease, and, in recent years, diabetes mellitus and systemic sclerosis, among other extraintestinal diseases. Several novel diagnostic tools for small intestinal bacterial overgrowth have emerged in recent years, and several therapeutic approaches have been proposed. Therefore, it has become necessary to find an effective, safe, and simple diagnostic method and a safe treatment modality. This article provides a review of current diagnostic and therapeutic approaches to small intestinal bacterial overgrowth.

关键词： Gastrointestinal Microbiome small intestinal bacterial overgrowth Hydrogen Breath Test Jejunal Aspirated Culture Review

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Patients with breath test positive are necessary to be identified from irritable bowel syndrome:a clinical trial based on microbiomics and rifaximin sensitivity

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Chinese Medical Journal 2022年第14期135卷 1716-1727页

作者： Zuojing Liu Shiwei Zhu Meibo He Mo Li Hui Wei Lu Zhang Qinghua Sun Qiong Jia Nan Hu Yuan Fang Lijin Song Chen Zhou Heqing Tao John Y Kao Huaiqiu Zhu Chung Owyang Liping Duan Department of Gastroenterology Peking University Third HospitalHaidian DistrictBeijing 100191China Department of Ultrasound Peking University Third HospitalHaidian DistrictBeijing 100191China Institute of Systems Biomedicine School of Basic Medical SciencesPeking University Health Science CenterBeijing 100191China Department of Biomedical Engineering College of EngineeringPeking UniversityBeijing 100187China Division of Gastroenterology Department of Internal MedicineUniversity of Michigan Health System6520 MSRB ISPC 56821150 West Medical Center DriveAnn ArborMI 48109USA

Background:As a non-invasive and effective diagnostic method for small intestinal bacterial overgrowth(SIBO),wild-use of breath test(BT)has demonstrated a high comorbidity rate in patients with diarrhea-predominant irritable bowel syndrome(IBS-D)and *** overlapping with SIBO respond better to rifaximin therapy than those with IBS-D *** microbiota plays a critical role in both of these two *** aimed to determine the microbial difference between IBS-D overlapping with/without SIBO,and to study the underlying mechanism of its sensitivity to ***:Patients with IBS-D were categorized as BT-negative(IBSN)and BT-positive(IBSP).Healthy volunteers(BT-negative)were enrolled as healthy *** patients were clinically evaluated before and after rifaximin treatment(0.4 g bid,4 weeks).Blood,intestine,and stool samples were collected for cytokine assessment and gut microbial ***:Clinical complaints and microbial abundance were significantly higher in IBSP than in *** contrast,severe systemic inflammation and more active bacterial invasion function that were associated with enrichment of opportunistic pathogens were seen in *** symptoms of IBSP patients were relieved in different degrees after therapy,but the symptoms of IBSN rarely *** also found that the presence of IBSN-enriched genera(Enterobacter and Enterococcus)are unaffected by rifaximin ***:IBS-D patients overlapping with SIBO showed noticeably different fecal microbial composition and function compared with IBS-D *** better response to rifaximin in those comorbid patients might associate with their different gut microbiota,which suggests that BT is necessary before IBS-D diagnosis and use of ***:Chinese Clinical Trial Registry,ChiCTR1800017911.

关键词： Irritable bowel syndrome small intestinal bacterial overgrowth Breath test Gut microbiota Rifaximin

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Prevalence of restless legs syndrome in patients with irritable bowel syndrome

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World Journal of Gastroenterology 2011年第39期17卷 4404-4407页

作者： P Patrick Basu N James Shah Nithya Krishnaswamy Tommy Pacana Gastroenterology Hepatologyand Liver Trans-plantColumbia University College of Physicians and Surgeons Gastroenterology Hepatologyand Liver TransplantNew York Hospital Queens Internal Medicine Forest Hills HospitalForest Hills

AIM:To determine the prevalence of restless legs syndrome(RLS)in patients with irritable bowel syndrome(IBS).METHODS:Patients with diarrhea-predominant IBS(n=30),constipation-predominant IBS(n=30),or mixed-symptom IBS(n=30)were recruited from the community between March 2008 and February *** 200 mg three times daily was administered empirically to alleviate small intestinal bowel over-growth in all *** presence of RLS was assessed via an RLS questionnaire and ***:Twentysix patients with IBS(29%)were diagnosed with RLS using the RLS ***-four of the 26 patients(92%)underwent polysomnog-raphy,and all had confirmation of RLS.A greater percentage of patients with RLS had diarrhea-predominant IBS(62%)compared with patients with constipation-predominant IBS(4%)or mixed-symptom IBS(33%).CONCLUSION:Restless legs syndrome is prevalent in patients with IBS,especially those with diarrheal *** of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.

关键词： Restless legs syndrome Irritable bowel syn-drome small intestinal bacterial overgrowth Prevalence

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Probiotic effects on intestinal fermentation patterns in patients with irritable bowel syndrome

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World Journal of Gastroenterology 2008年第32期14卷 5020-5024页

作者： Jacqueline S Barrett Kim EK Canale Richard B Gearry Peter M Irving Peter R Gibson Monash University Department of Medicine and Department of Gastroenterology Box Hill Hospital

AIM： To determine whether Lactobacillus casei strain Shirota （Yakult） can alter small intestinal bacterial overgrowth （SIBO）, as tested by the lactulose breath test, and whether this is associated with changes in symptoms in irritable bowel syndrome （IBS）. METHODS： 18 patients with IBS （Rome Ⅱ criteria）, who showed an early rise in breath hydrogen with lactulose （ERBHAL）, consumed 65 mL of Yakult daily for 6 wk. Lactulose breath test was repeated at the end of the treatment period. Symptoms were recorded daily using a 10 cm visual analogue scale. RESULTS： 14 patients completed the study, 9 （64%） had reversal of ERBHAL, with the median time of first rise in breath hydrogen increasing from 45 to 75 min （P = 0.03）. There was no significant improvement in the symptom score with probiotic therapy, except for wind （P = 0.04）. Patients commencing with at least moderate symptoms and who no longer had ERBHAL at the end of treatment, showed improvement in the overall symptoms scores [median final score 5.3 （IQR 3.9-5.9）, 55% reduction; n = 6] to a greater extent than those who had had persisting ERBHAL [final score 6.9 （5.0-7.0）, 12% reduction; n = 5; P = 0.18]. CONCLUSION： Yakult is effective in altering fermentation patterns in the small bowel, consistent with reducing SIBO. The loss of ERBHAL was associated with reduced symptoms. The true interpretation of these findings awaits a randornised, controlled trial.

关键词： Probiotics small intestinal bacterial overgrowth Breath hydrogen testing Functional gut symptoms

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Washed microbiota transplantation reduces proton pump inhibitor dependency in nonerosive reflux disease

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World Journal of Gastroenterology 2021年第6期27卷 513-522页

作者： Ya-Mei Zheng Xian-Yun Chen Jie-Yi Cai Yu Yuan Wen-Rui Xie Jia-Ting Xu Harry Hua-Xiang Xia Min Zhang Xing-Xiang He Li-Hao Wu Department of Gastroenterology The First Affiliated Hospital of Guangdong Pharmaceutical UniversityResearch Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong ProvinceGuangzhou 510030Guangdong ProvinceChina Department of Science and Education The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou 510030Guangdong ProvinceChina Department of Epidemiology and Health Statistics Guangdong Pharmaceutical UniversityGuangzhou 510220Guangdong ProvinceChina

BACKGROUND The pathogenesis of gastroesophageal reflux disease(GERD)is closely associated with the intestinal bacteria composition and their *** To investigate whether washed microbiota transplantation(WMT)improves symptoms of nonerosive reflux disease(NERD)with proton pump inhibitor(PPI)*** Patients with recurrent NERD and PPI dependency at the First Affiliated Hospital of Guangdong Pharmaceutical University from 2017 to 2018 were included and divided into a WMT or PPI group treated with PPI with/without *** endpoint was NERD symptom frequency evaluated 1 mo after WMT using reflux disease questionnaire(RDQ)and GERD questionnaire(GERDQ)scores,remission time,PPI dose,and the examination of intestinal mucosal barrier *** In the WMT(n=15)and PPI(n=12)groups,the total remission rate at 1 mo after treatment was 93.3%vs 41.7%.Compared with the PPI group,the WMT group showed better results in GERDQ(P=0.004)and RDQ(P=0.003)and in remission months(8 vs 2,P=0.002).The PPI dose was reduced to some extent for 80%of patients in the WMT group and 33.3%in the PPI *** 24 patients,intestinal mucosal barrier function was examined before treatment,and changes in the degree of damage were observed in 13 of these patients after *** one of the 15 patients had minor side effects,including a mushy stool two or three times a day,which resolved on their own after 1 *** This study is the first to demonstrate that WMT may be safe and effective for relieving NERD symptoms and reducing PPI dependency and recurrence.

关键词： Nonerosive reflux disease Washed microbiota transplantation Proton pump inhibitor dependency intestinal bacteria Lipopolysaccharide small intestinal bacterial overgrowth

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