Concept: Small bowel bacterial overgrowth syndrome
To explore whether patients with a defective ileocecal valve (ICV)/cecal distension reflex have small intestinal bacterial overgrowth.
Small intestinal bacterial overgrowth (SIBO) is considered to be involved in the pathogenesis of functional gastrointestinal disorders (FGID). However, the prevalence and clinical conditions of SIBO in patients with FGID remain to be fully elucidated. Here, we examined the frequency of SIBO in patients with refractory FGID.
The composition of the intestinal microbiota seems to be an important factor in determining the clinical outcome in children with short bowel syndrome (SBS). Alterations in the microbiota may result in serious complications such as small bowel bacterial overgrowth (SBBO) and intestinal mucosal inflammation that lead to prolonged parenteral nutrition (PN) dependency with subsequently increased risk of liver failure and sepsis. To date, there are no reported mappings of the intestinal microbiome in children with SBS. Here, we present the first report on the intestinal microbial community profile in children with SBS.
The symptoms and signs of small intestinal bacterial overgrowth (SIBO) are often identical to a variety of diseases and can lead to diagnostic confusion.
Exocrine pancreatic insufficiency (EPI) is one of the possible mechanisms of fat maldigestion following gastric surgery, together with reduced food intake, loss of gastric reservoir, small bowel bacterial overgrowth and rapid small bowel transit. Oral pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for EPI. The efficacy and safety of pancreatic enzyme substitution in patients following gastric resection remains unclear. This review article summarizes relevant studies addressing PERT after gastric resection.
Prolonged suppression of gastric acid secretion by proton pump inhibitors (PPIs) may alter the bacterial microbiota of the upper gastrointestinal tract and lead to small bowel bacterial overgrowth (SBBO). Published reports have shown conflicting results on the association between PPI therapy and risk of SBBO development. We evaluated whether long-term PPI treatment is associated with presence of SBBO as determined by breath hydrogen (H2) and methane (CH4) excretion. We also assessed the differences in H2 / CH4 excretion patterns in patients taking PPI compared with those not taking the medication and searched for the potential predictors of a positive breath test result. Material and methods: This was a prospective cohort study that included 67 PPI treated patients (PPIT) and 62 not-receiving PPI (C, comparison). PPIT and C underwent a glucose H2 / CH4 breath test (HMBT) to determine the presence of SBBO. Results: The prevalence of SBBO was significantly higher in PPIT compared to C (44.8% vs 21%, p=0.005, OR = 3.06, 95% CI 1.40-6.66) as determined by H2 and CH4 excretion. We found that PPIT had all H2 test parameters (baseline H2 levels, maximum peak of H2 as well as mean H2 through the whole test) significantly higher than C. Even those PPIT who did not meet criteria of breath test positivity had statistically higher breath H2 levels compared to C. Although we did not observe significant differences in CH4 excretion between groups, 19.4% of PPIT and 12.9% of C would have had a false-negative HMBT results had CH4 not been taken into account. Conclusions: Long-term PPI use was found to be significantly associated with the SBBO development as determined by breath H2 and CH4 excretion. CH4 determination reduces the number of falsely negative test results.
We describe 3 patients with short bowel syndrome who had persistently elevated serum methylmalonic acid (MMA) levels while being treated for vitamin B12 deficiency. Following treatment for presumed small bowel bacterial overgrowth, MMA levels normalized. Among patients with short bowel syndrome, MMA levels may have limited specificity for vitamin B12 deficiency.
To analyze the fecal microbiota composition of children living in an urban slum in Brazil, with or without small intestinal bacterial overgrowth, and to investigate the occurrence of stunting and anemia.
Though pathogenesis of non-alcoholic steatohepatitis (NASH) is unclear, association with small intestinal bacterial overgrowth [SIBO] and fecal dysbiosis is suggested. We evaluated SIBO in NASH using quantitative jejunal aspirate culture (conventional criteria: ≥ 10(5) colony forming unit (CFU)/mL and newer cutoff ≥ 10(3) CFU/mL) and glucose hydrogen breath test.
Rifaximin might decrease the risk of portal hypertension-related complications by controlling small intestinal bacterial overgrowth.