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Erschienen in: Digestive Diseases and Sciences 9/2018

14.05.2018 | Original Article

Testing and Treating Small Intestinal Bacterial Overgrowth Reduces Symptoms in Patients with Inflammatory Bowel Disease

verfasst von: Shirley Cohen-Mekelburg, Zaid Tafesh, Elliot Coburn, Russell Weg, Neena Malik, Colleen Webb, Hoda Hammad, Ellen Scherl, Brian P. Bosworth

Erschienen in: Digestive Diseases and Sciences | Ausgabe 9/2018

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Abstract

Background

Common mechanisms against small intestinal bacterial overgrowth (SIBO), including an intact ileocecal valve, gastric acid secretion, intestinal motility, and an intact immune system, are compromised in inflammatory bowel disease (IBD), and therefore, a relatively high incidence of SIBO has been reported in this population.

Aims

We aimed to determine whether an improvement in IBD clinical activity scores is seen after testing and treating SIBO.

Methods

A retrospective cohort study of 147 patients with inflammatory bowel disease who were referred for SIBO breath testing from 1/2012 to 5/2016 was performed. Characteristics of SIBO positive and treated patients were compared to SIBO negative patients, including the changes in Partial Mayo Score or Harvey Bradshaw Index (HBI), using Student’s t test for continuous variables and Chi-squared or Fisher’s exact test for categorical variables.

Results

61.9% were SIBO positive and treated, and 38.1% were SIBO negative. In Crohn’s disease, the median HBI decreased from 5 to 3 and 5 to 4, in the SIBO positive and negative groups, respectively (p = 0.005). In ulcerative colitis, the Partial Mayo Score decreased from 2 to 1.5 and 2 to 1, respectively (p = 0.607).

Conclusions

This study examines the clinical effect of testing and treating for SIBO in an IBD population. We see a significant reduction in HBI after testing for and treating SIBO. Future prospective studies are necessary to further investigate the role of SIBO in the evaluation and management of IBD.
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Literatur
1.
Zurück zum Zitat Moraru IG, Moraru AG, Andrei M, et al. Small intestinal bacterial overgrowth is associated to symptoms in irritable bowel syndrome. Evidence from a multicentre study in Romania. Rom J Intern Med. 2014;52:143–150.PubMed Moraru IG, Moraru AG, Andrei M, et al. Small intestinal bacterial overgrowth is associated to symptoms in irritable bowel syndrome. Evidence from a multicentre study in Romania. Rom J Intern Med. 2014;52:143–150.PubMed
2.
Zurück zum Zitat Lee JM, Lee KM, Chung YY, et al. Clinical significance of the glucose breath test in patients with inflammatory bowel disease. J Gastroenterol Hepatol. 2015;30:990–994.CrossRefPubMed Lee JM, Lee KM, Chung YY, et al. Clinical significance of the glucose breath test in patients with inflammatory bowel disease. J Gastroenterol Hepatol. 2015;30:990–994.CrossRefPubMed
3.
Zurück zum Zitat Rana SV, Sharma S, Malik A, et al. Small intestinal bacterial overgrowth and orocecal transit time in patients of inflammatory bowel disease. Dig Dis Sci. 2013;58:2594–2598.CrossRefPubMed Rana SV, Sharma S, Malik A, et al. Small intestinal bacterial overgrowth and orocecal transit time in patients of inflammatory bowel disease. Dig Dis Sci. 2013;58:2594–2598.CrossRefPubMed
4.
Zurück zum Zitat Klaus J, Spaniol U, Adler G, Mason RA, Reinshagen M, von Tirpitz CC. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn’s Disease. BMC Gastroenterol. 2009;9:61.CrossRefPubMedPubMedCentral Klaus J, Spaniol U, Adler G, Mason RA, Reinshagen M, von Tirpitz CC. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn’s Disease. BMC Gastroenterol. 2009;9:61.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Castiglione F, Del Vecchio Blanco G, Rispo A, et al. Orocecal transit time and bacterial overgrowth in patients with Crohn’s disease. J Clin Gastroenterol. 2000;31:63–66.CrossRefPubMed Castiglione F, Del Vecchio Blanco G, Rispo A, et al. Orocecal transit time and bacterial overgrowth in patients with Crohn’s disease. J Clin Gastroenterol. 2000;31:63–66.CrossRefPubMed
6.
Zurück zum Zitat Mishkin D, Boston FM, Blank D, Yalovsky M, Mishkin S. The glucose breath test: a diagnostic test for small bowel stricture(s) in Crohn’s disease. Dig Dis Sci. 2002;47:489–494.CrossRefPubMed Mishkin D, Boston FM, Blank D, Yalovsky M, Mishkin S. The glucose breath test: a diagnostic test for small bowel stricture(s) in Crohn’s disease. Dig Dis Sci. 2002;47:489–494.CrossRefPubMed
7.
Zurück zum Zitat Rutgeerts P, Ghoos Y, Vantrappen G, Eyssen H. Ileal dysfunction and bacterial overgrowth in patients with Crohn’s disease. Eur J Clin Invest. 1981;11:199–206.CrossRefPubMed Rutgeerts P, Ghoos Y, Vantrappen G, Eyssen H. Ileal dysfunction and bacterial overgrowth in patients with Crohn’s disease. Eur J Clin Invest. 1981;11:199–206.CrossRefPubMed
8.
Zurück zum Zitat Sánchez-Montes C, Ortiz V, Bastida G, et al. Small intestinal bacterial overgrowth in inactive Crohn’s disease: influence of thiopurine and biological treatment. World J Gastroenterol. 2014;20:13999–14003.CrossRefPubMedPubMedCentral Sánchez-Montes C, Ortiz V, Bastida G, et al. Small intestinal bacterial overgrowth in inactive Crohn’s disease: influence of thiopurine and biological treatment. World J Gastroenterol. 2014;20:13999–14003.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Adike A, DiBaise JK. Small intestinal bacterial overgrowth: nutritional implications, diagnosis, and management. Gastroenterol Clin North Am. 2018;47:193–208.CrossRefPubMed Adike A, DiBaise JK. Small intestinal bacterial overgrowth: nutritional implications, diagnosis, and management. Gastroenterol Clin North Am. 2018;47:193–208.CrossRefPubMed
10.
Zurück zum Zitat Rezaie A, Pimentel M, Rao SS. How to test and treat small intestinal bacterial overgrowth: an evidence-based approach. Curr Gastroenterol Rep. 2016;18:8.CrossRefPubMed Rezaie A, Pimentel M, Rao SS. How to test and treat small intestinal bacterial overgrowth: an evidence-based approach. Curr Gastroenterol Rep. 2016;18:8.CrossRefPubMed
11.
12.
Zurück zum Zitat Zhong C, Qu C, Wang B, Liang S, Zeng B. Probiotics for preventing and treating small intestinal bacterial overgrowth: a meta-analysis and systematic review of current evidence. J Clin Gastroenterol. 2017;51:300–311.CrossRefPubMed Zhong C, Qu C, Wang B, Liang S, Zeng B. Probiotics for preventing and treating small intestinal bacterial overgrowth: a meta-analysis and systematic review of current evidence. J Clin Gastroenterol. 2017;51:300–311.CrossRefPubMed
13.
Zurück zum Zitat Rezaie A, Buresi M, Lembo A, et al. Hydrogen and methane-based breath testing in gastrointestinal disorders: the North American consensus. Am J Gastroenterol. 2017;112:775–784.CrossRefPubMedPubMedCentral Rezaie A, Buresi M, Lembo A, et al. Hydrogen and methane-based breath testing in gastrointestinal disorders: the North American consensus. Am J Gastroenterol. 2017;112:775–784.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Lo WK, Chan WW. Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: a meta-analysis. Clin Gastroenterol Hepatol. 2013;11:483–490.CrossRefPubMed Lo WK, Chan WW. Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: a meta-analysis. Clin Gastroenterol Hepatol. 2013;11:483–490.CrossRefPubMed
15.
Zurück zum Zitat Pimentel M. Breath testing for small intestinal bacterial overgrowth: should we bother? Am J Gastroenterol. 2016;111:307–308.CrossRefPubMed Pimentel M. Breath testing for small intestinal bacterial overgrowth: should we bother? Am J Gastroenterol. 2016;111:307–308.CrossRefPubMed
Metadaten
Titel
Testing and Treating Small Intestinal Bacterial Overgrowth Reduces Symptoms in Patients with Inflammatory Bowel Disease
verfasst von
Shirley Cohen-Mekelburg
Zaid Tafesh
Elliot Coburn
Russell Weg
Neena Malik
Colleen Webb
Hoda Hammad
Ellen Scherl
Brian P. Bosworth
Publikationsdatum
14.05.2018
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 9/2018
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5109-1

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