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Small intestinal bacterial overgrowth is associated with irritable bowel syndrome and is independent of proton pump inhibitor usage.

Giamarellos-Bourboulis EJ, Pyleris E, Barbatzas C, Pistiki A, Pimentel M - BMC Gastroenterol (2016)

Bottom Line: Current knowledge suggests that small intestinal overgrowth participates in the pathogenesis of irritable bowel syndrome.It is questionable if this association is modulated by intake of proton pump inhibitors (PPIs).Multiple logistic regression analysis found that factors independently associated with SIBO were age above or equal to 60 years (OR: 2.36), body mass index more than or equal to 22 kg/m(2) (OR: 0.60), presence of IBS (OR: 6.29), type 2 diabetes mellitus (OR: 1.59) and gastritis (OR: 0.47).

View Article: PubMed Central - PubMed

Affiliation: 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece. egiamarel@med.uoa.gr.

ABSTRACT

Background: Current knowledge suggests that small intestinal overgrowth participates in the pathogenesis of irritable bowel syndrome. It is questionable if this association is modulated by intake of proton pump inhibitors (PPIs).

Methods: In a prospective study, quantitative cultures of duodenal aspirates were performed for aerobic species in 897 consecutive patients undergoing upper GI tract endoscopy. SIBO was defined as equal to or more than 10(3) cfu/ml. The effect of PPI intake on the relationship between SIBO and IBS was the primary endpoint.

Results: Analysis among patients without any history of PPI intake (n = 713) showed that odds ratio (OR) for IBS in the event of SIBO was 5.63 (3.73-8.51, p < 0.0001); this was 4.16 (1.91-9.06) when analysis was done among patients with history of PPI intake (n = 184, p: 0.498 between patients without and with PPI intake). Multiple logistic regression analysis found that factors independently associated with SIBO were age above or equal to 60 years (OR: 2.36), body mass index more than or equal to 22 kg/m(2) (OR: 0.60), presence of IBS (OR: 6.29), type 2 diabetes mellitus (OR: 1.59) and gastritis (OR: 0.47).

Conclusions: The association between IBS and SIBO was completely independent from PPI intake. Although gastritis was protective against SIBO, results show that PPI intake cannot prime SIBO.

No MeSH data available.


Related in: MedlinePlus

Lack of association between bacterial growth in duodenal aspirates and history of PPI intake a Bacterial growth in patients without history of PPI intake [PPIs(-)] and patients with history of PPI intake [PPIs(+)]; b Bacterial growth in patients with IBS predominant diarrhea [IBS-D(+)] and the rest of patients [IBS-D(-)] in relation to the time of PPI intake. P values show differences of the indicated comparisons
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Fig2: Lack of association between bacterial growth in duodenal aspirates and history of PPI intake a Bacterial growth in patients without history of PPI intake [PPIs(-)] and patients with history of PPI intake [PPIs(+)]; b Bacterial growth in patients with IBS predominant diarrhea [IBS-D(+)] and the rest of patients [IBS-D(-)] in relation to the time of PPI intake. P values show differences of the indicated comparisons

Mentions: Analysed patients were divided into those without history of recent PPI intake (n = 713) and into those with history of recent PPI intake (n = 184). The absolute counts of bacteria in the duodenal aspirates did not differ between groups (Fig. 2a).Fig. 2


Small intestinal bacterial overgrowth is associated with irritable bowel syndrome and is independent of proton pump inhibitor usage.

Giamarellos-Bourboulis EJ, Pyleris E, Barbatzas C, Pistiki A, Pimentel M - BMC Gastroenterol (2016)

Lack of association between bacterial growth in duodenal aspirates and history of PPI intake a Bacterial growth in patients without history of PPI intake [PPIs(-)] and patients with history of PPI intake [PPIs(+)]; b Bacterial growth in patients with IBS predominant diarrhea [IBS-D(+)] and the rest of patients [IBS-D(-)] in relation to the time of PPI intake. P values show differences of the indicated comparisons
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940948&req=5

Fig2: Lack of association between bacterial growth in duodenal aspirates and history of PPI intake a Bacterial growth in patients without history of PPI intake [PPIs(-)] and patients with history of PPI intake [PPIs(+)]; b Bacterial growth in patients with IBS predominant diarrhea [IBS-D(+)] and the rest of patients [IBS-D(-)] in relation to the time of PPI intake. P values show differences of the indicated comparisons
Mentions: Analysed patients were divided into those without history of recent PPI intake (n = 713) and into those with history of recent PPI intake (n = 184). The absolute counts of bacteria in the duodenal aspirates did not differ between groups (Fig. 2a).Fig. 2

Bottom Line: Current knowledge suggests that small intestinal overgrowth participates in the pathogenesis of irritable bowel syndrome.It is questionable if this association is modulated by intake of proton pump inhibitors (PPIs).Multiple logistic regression analysis found that factors independently associated with SIBO were age above or equal to 60 years (OR: 2.36), body mass index more than or equal to 22 kg/m(2) (OR: 0.60), presence of IBS (OR: 6.29), type 2 diabetes mellitus (OR: 1.59) and gastritis (OR: 0.47).

View Article: PubMed Central - PubMed

Affiliation: 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece. egiamarel@med.uoa.gr.

ABSTRACT

Background: Current knowledge suggests that small intestinal overgrowth participates in the pathogenesis of irritable bowel syndrome. It is questionable if this association is modulated by intake of proton pump inhibitors (PPIs).

Methods: In a prospective study, quantitative cultures of duodenal aspirates were performed for aerobic species in 897 consecutive patients undergoing upper GI tract endoscopy. SIBO was defined as equal to or more than 10(3) cfu/ml. The effect of PPI intake on the relationship between SIBO and IBS was the primary endpoint.

Results: Analysis among patients without any history of PPI intake (n = 713) showed that odds ratio (OR) for IBS in the event of SIBO was 5.63 (3.73-8.51, p < 0.0001); this was 4.16 (1.91-9.06) when analysis was done among patients with history of PPI intake (n = 184, p: 0.498 between patients without and with PPI intake). Multiple logistic regression analysis found that factors independently associated with SIBO were age above or equal to 60 years (OR: 2.36), body mass index more than or equal to 22 kg/m(2) (OR: 0.60), presence of IBS (OR: 6.29), type 2 diabetes mellitus (OR: 1.59) and gastritis (OR: 0.47).

Conclusions: The association between IBS and SIBO was completely independent from PPI intake. Although gastritis was protective against SIBO, results show that PPI intake cannot prime SIBO.

No MeSH data available.


Related in: MedlinePlus