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Erschienen in: Digestive Diseases and Sciences 3/2014

01.03.2014 | Original Article

The Impact of Alcohol Consumption and Cholecystectomy on Small Intestinal Bacterial Overgrowth

verfasst von: Scott L. Gabbard, Brian E. Lacy, Gary M. Levine, Michael D. Crowell

Erschienen in: Digestive Diseases and Sciences | Ausgabe 3/2014

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Abstract

Background

The etiology of small intestinal bacterial overgrowth (SIBO) is diverse and frequently multi-factorial. SIBO is thought to result from structural changes of the gastrointestinal tract, disordered peristalsis of the stomach and/or small intestine, or a disruption of the normal mucosal defenses of the small intestine. Alcoholics are reported to have higher rates of SIBO, as diagnosed by jejunal aspirate; however, no data are available on the association between moderate alcohol consumption and SIBO.

Aim

To evaluate the association between moderate alcohol consumption and SIBO and identify risk factors for SIBO using the lactulose breath test (LBT).

Methods

A retrospective chart review was completed for 210 consecutive patients who underwent the LBT between 2008 and 2010. We reviewed demographic data, including age, race, body mass index, alcohol and tobacco history, medication use, comorbid medical conditions, and history of abdominal surgery.

Results

The study included 196 patients (68 % female; mean age 55 years), 93 of whom had a positive LBT (47.4 %). Of those patients who consumed a moderate amount of alcohol, 58 % had a positive LBT, compared to 38.9 % of abstainers (P = 0.008). Those with a history of cholecystectomy had significantly lower rates of a positive LBT than those who had not (33.3 vs. 51.7 % respectively; P = 0.031). Neither proton pump inhibitor (PPI) use nor tobacco use was associated with a positive LBT.

Conclusion

In this retrospective review, moderate alcohol consumption was a strong risk factor for SIBO. Cholecystectomy appeared to be protective against SIBO. Neither PPI use nor tobacco use was associated with an increased risk of SIBO.
Literatur
1.
Zurück zum Zitat Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterol Hepatol. 2007;3:112–122. Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterol Hepatol. 2007;3:112–122.
2.
Zurück zum Zitat Ratuapli S, Ellington T, O’Neil MT, et al. Proton pump inhibitor therapy use does not predispose to small intestinal bacterial overgrowth. Am J Gastroenterol. 2012;107:730–735.PubMedCrossRef Ratuapli S, Ellington T, O’Neil MT, et al. Proton pump inhibitor therapy use does not predispose to small intestinal bacterial overgrowth. Am J Gastroenterol. 2012;107:730–735.PubMedCrossRef
3.
Zurück zum Zitat Law D, Pimentel M. Proton pump inhibitor therapy does not affect hydrogen production on lactulose breath test in subjects with IBS. Dig Dis Sci. 2010;55:2302–2308.PubMedCrossRef Law D, Pimentel M. Proton pump inhibitor therapy does not affect hydrogen production on lactulose breath test in subjects with IBS. Dig Dis Sci. 2010;55:2302–2308.PubMedCrossRef
4.
Zurück zum Zitat Fine D, Shiller L. American Gastroenterological Association medical position statement: guidelines for the evaluation and management of chronic diarrhea. Gastroenterology. 1999;116:1461–1463.CrossRef Fine D, Shiller L. American Gastroenterological Association medical position statement: guidelines for the evaluation and management of chronic diarrhea. Gastroenterology. 1999;116:1461–1463.CrossRef
5.
Zurück zum Zitat Bode JC, Bode C, Heidelbach R, et al. Jejunal microflora in patients with chronic alcohol abuse. Hepatogastroenterology. 1984;30:30–34. Bode JC, Bode C, Heidelbach R, et al. Jejunal microflora in patients with chronic alcohol abuse. Hepatogastroenterology. 1984;30:30–34.
6.
Zurück zum Zitat Hauge T, Persson J, Danielsson D. Mucosal bacterial growth in the upper gastrointestinal tract in alcoholics (heavy drinkers). Digestion. 1997;58:591–595.PubMedCrossRef Hauge T, Persson J, Danielsson D. Mucosal bacterial growth in the upper gastrointestinal tract in alcoholics (heavy drinkers). Digestion. 1997;58:591–595.PubMedCrossRef
7.
Zurück zum Zitat Bode JC, Knuppel H, et al. Activities of cytoplasmic, mitochondrial, and brush border enzymes in jejunal mucosa of chronic alcoholics. Z Gastroenterol. 1982;20:228–233.PubMed Bode JC, Knuppel H, et al. Activities of cytoplasmic, mitochondrial, and brush border enzymes in jejunal mucosa of chronic alcoholics. Z Gastroenterol. 1982;20:228–233.PubMed
8.
Zurück zum Zitat Beck IT, Dinda PK. Acute exposure of small intestine to ethanol. Effects on morphology and function. Dig Dis Sci. 1981;26:817–838.PubMedCrossRef Beck IT, Dinda PK. Acute exposure of small intestine to ethanol. Effects on morphology and function. Dig Dis Sci. 1981;26:817–838.PubMedCrossRef
9.
Zurück zum Zitat Bode C, Bode JC. Effect of alcohol consumption on the gut. Best Pract Res Clin Gastroenterol. 2003;17:575–592.PubMedCrossRef Bode C, Bode JC. Effect of alcohol consumption on the gut. Best Pract Res Clin Gastroenterol. 2003;17:575–592.PubMedCrossRef
10.
Zurück zum Zitat Addolorato G, Capristo E, Gasbarrini G, Stefani GF. Depression, alcohol abuse and orocaecal transit time. Gut. 1997;41:417–418.PubMedCrossRef Addolorato G, Capristo E, Gasbarrini G, Stefani GF. Depression, alcohol abuse and orocaecal transit time. Gut. 1997;41:417–418.PubMedCrossRef
11.
Zurück zum Zitat Maier A, Bode C, Fritz P, Bode JC. Effects of chronic alcohol abuse on duodenal mononuclear cells in man. Dig Dis Sci. 1999;44:691–696.PubMedCrossRef Maier A, Bode C, Fritz P, Bode JC. Effects of chronic alcohol abuse on duodenal mononuclear cells in man. Dig Dis Sci. 1999;44:691–696.PubMedCrossRef
12.
Zurück zum Zitat United States Department of Agriculture and United States Department of Health and Human Services. Foods and food components to reduce. In: Dietary guidelines for Americans.; chap. 3. Washington, DC: US Government Printing Office; 2010:30–31. United States Department of Agriculture and United States Department of Health and Human Services. Foods and food components to reduce. In: Dietary guidelines for Americans.; chap. 3. Washington, DC: US Government Printing Office; 2010:30–31.
13.
14.
Zurück zum Zitat Saad RJ, Chey W. Breath tests for gastrointestinal disease: the real deal or just a lot of hot air? Gastroenterology. 2007;133:1763–1766.PubMedCrossRef Saad RJ, Chey W. Breath tests for gastrointestinal disease: the real deal or just a lot of hot air? Gastroenterology. 2007;133:1763–1766.PubMedCrossRef
15.
Zurück zum Zitat Casini A, Galli A, et al. Ethanol-induced alterations of matrix network in the duodenal mucosa of chronic alcohol abusers. Virchows Arch. 1999;2:127–135.CrossRef Casini A, Galli A, et al. Ethanol-induced alterations of matrix network in the duodenal mucosa of chronic alcohol abusers. Virchows Arch. 1999;2:127–135.CrossRef
16.
Zurück zum Zitat Centers for Disease Control and Prevention (CDC). Summary Health Statistics for U.S. Adults: National Health Interview Survey. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2010. Centers for Disease Control and Prevention (CDC). Summary Health Statistics for U.S. Adults: National Health Interview Survey. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2010.
17.
Zurück zum Zitat Marway JS, Preedy VR. The acute effects of ethanol and acetaldehyde on the synthesis of mixed and contractile proteins of the jejunum. Alcohol. 1995;30:211–217. Marway JS, Preedy VR. The acute effects of ethanol and acetaldehyde on the synthesis of mixed and contractile proteins of the jejunum. Alcohol. 1995;30:211–217.
18.
Zurück zum Zitat Sibley D, Jerrells TR. Alcohol consumption by C57BL/6 mice is associated with depletion of lymphoid cells from the gut-associated lymphoid tissues and altered resistance to oral infections with Salmonella typhimurium. J Infect Dis. 2000;182:482–489.PubMedCrossRef Sibley D, Jerrells TR. Alcohol consumption by C57BL/6 mice is associated with depletion of lymphoid cells from the gut-associated lymphoid tissues and altered resistance to oral infections with Salmonella typhimurium. J Infect Dis. 2000;182:482–489.PubMedCrossRef
19.
Zurück zum Zitat Bode JC, Knüppel H, et al. Quantitative histomorphometric study of the jejunal mucosa in chronic alcoholics. Digestion. 1982;23:265–270.PubMedCrossRef Bode JC, Knüppel H, et al. Quantitative histomorphometric study of the jejunal mucosa in chronic alcoholics. Digestion. 1982;23:265–270.PubMedCrossRef
20.
Zurück zum Zitat Levin I, Meiri G, Peretz M, et al. The ternary complex of Pseudomonas aeruginosa alcohol dehydrogenase with NADH and ethylene glycol. Protein Sci. 2004;13:1547–1556.PubMedCrossRef Levin I, Meiri G, Peretz M, et al. The ternary complex of Pseudomonas aeruginosa alcohol dehydrogenase with NADH and ethylene glycol. Protein Sci. 2004;13:1547–1556.PubMedCrossRef
21.
Zurück zum Zitat Chávez-Pacheco JL, Contreras-Zentella M, Membrillo-Hernández J, et al. The quinohaemoprotein alcohol dehydrogenase from Gluconacetobacter xylinus: molecular and catalytic properties. Arch Microbiol. 2010;192:703–713.PubMedCrossRef Chávez-Pacheco JL, Contreras-Zentella M, Membrillo-Hernández J, et al. The quinohaemoprotein alcohol dehydrogenase from Gluconacetobacter xylinus: molecular and catalytic properties. Arch Microbiol. 2010;192:703–713.PubMedCrossRef
22.
Zurück zum Zitat Breuer NF, Jaekel S, Dommes P, et al. Fecal bile acid excretion pattern in cholecystectomized patients. Dig Dis Sci. 1986;31:953–960.PubMedCrossRef Breuer NF, Jaekel S, Dommes P, et al. Fecal bile acid excretion pattern in cholecystectomized patients. Dig Dis Sci. 1986;31:953–960.PubMedCrossRef
23.
Zurück zum Zitat Inagaki T, Moschetta A, Lee YK, et al. Regulation of antibacterial defense in the small intestine by the nuclear bile acid receptor. Proc Nat Acad Sci. 2006;103:3920–3925.PubMedCrossRef Inagaki T, Moschetta A, Lee YK, et al. Regulation of antibacterial defense in the small intestine by the nuclear bile acid receptor. Proc Nat Acad Sci. 2006;103:3920–3925.PubMedCrossRef
24.
Zurück zum Zitat Gasbarrini A, Corazza G, Gasbarrini G, et al. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther. 2009;29:1–49.PubMed Gasbarrini A, Corazza G, Gasbarrini G, et al. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther. 2009;29:1–49.PubMed
25.
Zurück zum Zitat Yu D, Cheeseman F, Vanner S. Combined oro-caecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS. Gut. 2011;60:334–340.PubMedCrossRef Yu D, Cheeseman F, Vanner S. Combined oro-caecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS. Gut. 2011;60:334–340.PubMedCrossRef
26.
Zurück zum Zitat Perman JA, Modler S, Barr RG, et al. Fasting breath hydrogen concentration: normal values and clinical application. Gastroenterology. 1984;87:1358–1363.PubMed Perman JA, Modler S, Barr RG, et al. Fasting breath hydrogen concentration: normal values and clinical application. Gastroenterology. 1984;87:1358–1363.PubMed
27.
Zurück zum Zitat Ford AC, Spiegel BMR, Talley NJ, Moayyedi P. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7:1279–1286.PubMedCrossRef Ford AC, Spiegel BMR, Talley NJ, Moayyedi P. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7:1279–1286.PubMedCrossRef
28.
Zurück zum Zitat Del Boca F, Darkes J. The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction. 2003;98:1–12.PubMedCrossRef Del Boca F, Darkes J. The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction. 2003;98:1–12.PubMedCrossRef
29.
Zurück zum Zitat Pimentel M, Mayer AG, Park S, et al. Methane production during lactulose breath test is associated with gastrointestinal disease presentation. Dig Dis Sci. 2003;48:86–92.PubMedCrossRef Pimentel M, Mayer AG, Park S, et al. Methane production during lactulose breath test is associated with gastrointestinal disease presentation. Dig Dis Sci. 2003;48:86–92.PubMedCrossRef
Metadaten
Titel
The Impact of Alcohol Consumption and Cholecystectomy on Small Intestinal Bacterial Overgrowth
verfasst von
Scott L. Gabbard
Brian E. Lacy
Gary M. Levine
Michael D. Crowell
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 3/2014
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-013-2960-y

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