D0641 - The Use of Post-Prandial Breath Hydrogen to Monitor Antibiotic-Induced Changes in the Activity of the Gut Microbiome

Guillermo Barahona, MD, MBA¹, Aine Moran, BSc², Barry McBride, BEng, MSc², Kedrick Harrison, MPH², Luisa Villatoro, MD, MBA¹, Robert Burns, BS¹, Bo Konings, BSc³, Robert Bulat, MD, PhD¹, Megan McKnight, PA-C¹, Claire Shortt, BSc, PhD², Pankaj Jay Pasricha, MD, MBBS^1
1Johns Hopkins University, Baltimore, MD; ²FoodMarble, Dublin, Dublin, Ireland; ³Johns Hopkins University, Houthalen-Helchteren, Limburg, Belgium

Introduction: Small intestinal bacterial overgrowth (SIBO) is a common condition that is associated with a range of non-specific GI symptoms. Patients are often prescribed an empirical trial of antibiotics, however, response to treatment can vary. Due to the heterogeneous nature of symptoms experienced, post-prandial breath hydrogen (PPH₂) may assist in identifying beneficial changes in the activity of the gut microbiome in those with a dysbiotic phenotype.

Methods: 16 suspected SIBO patients measured their PPH₂ using an at-home, app-connected breath analyzer (AIRE®, FoodMarble). Readings were taken at 0, 30, 60, and 90 min after their morning and evening meals for 7 days pre and post-treatment. 14/16 patients followed this protocol during antibiotic treatment. Six controls measured their PPH₂ levels for 7 days. Gas normalization was defined as +2 SD of the mean PPH₂ in controls.

Results: Patients produced significantly more PPH₂ (p=0.003), 27 ppm ± 22 ppm (mean ± SD) than controls (13 ppm ± 7 ppm). 5/14 patients saw a transient increase (p=0.2) of 23 ppm ± 23 ppm (mean delta ± SD) of PPH₂ during treatment. Post-treatment, patients produced significantly less PPH₂ (p=0.00001), 17 ppm ± 13 ppm, more closely matching that of healthy controls, Fig 1.



Discussion: For the first time, PPH₂ was tracked before, during, and after antibiotic treatment. PPH₂ was significantly greater in patients. Interestingly, for some patients, PPH₂ increased during the treatment period, likely due to a dynamic rearrangement of certain microbial populations. Post-treatment, the level of PPH₂ in patients was more similar to that of healthy volunteers. The collection of PPH₂ data may be useful to identify those who produce elevated gas levels due to dysbiosis and to determine the normalization of their microbiome in response to antibiotics.







Disclosures:


Guillermo Barahona, MD, MBA¹, Aine Moran, BSc², Barry McBride, BEng, MSc², Kedrick Harrison, MPH², Luisa Villatoro, MD, MBA¹, Robert Burns, BS¹, Bo Konings, BSc³, Robert Bulat, MD, PhD¹, Megan McKnight, PA-C¹, Claire Shortt, BSc, PhD², Pankaj Jay Pasricha, MD, MBBS¹. D0641 - The Use of Post-Prandial Breath Hydrogen to Monitor Antibiotic-Induced Changes in the Activity of the Gut Microbiome, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.