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Small intestinal bacterial overgrowth in gastroparesis: are there any predictors?
J Clin Gastroenterol 2010; 44(1):e8-13JC

Abstract

BACKGROUND

There is some degree of overlap in the symptomatic spectrum of patients with gastroparesis and small intestinal bacterial overgrowth (SIBO) and some of the etiologies for gastroparesis, such as diabetes mellitus and vagotomy are known to predispose to SIBO. The aims of our study were to measure the prevalence of SIBO in a cohort of gastroparetic patients with prominence of abdominal pain and bloating and try to identify predictors with regard to demographics, concurrent use of medications such as prokinetics, proton pump inhibitors, and opiate analgesics, and predominant bowel movement abnormality.

METHODS

Glucose breath testing (GBT) for SIBO was performed in 50 patients (41 females) with gastroparesis. Demographic data, medication profiles, baseline and peak measurements of hydrogen or methane gas on the GBT, and results of the most recent gastric emptying scintigraphy test were recorded.

RESULTS

Thirty of fifty (60%) patients had a positive GBT for SIBO on the basis of hydrogen (63%), methane (27%), or both criteria (10%). SIBO was more likely (P=0.001) in patients with gastroparetic symptoms of greater duration (mean 5 y; 95% CI: 4-6 y). No significant differences were noted in both groups with regard to age, sex, or etiology of gastroparesis. Gastric emptying was similar in the SIBO and non-SIBO group (P>0.05). After adjusting for tegaserod and opiate analgesic use, 14/23 (61%) had a positive GBT.

CONCLUSIONS

SIBO is very common in gastroparetics with predominance of abdominal pain and bloating, especially those with a longer duration of gastroparesis. Awareness of SIBO in the setting of gastroparesis will facilitate separation of the 2 entities and allow appropriate therapies to be instituted.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20027008

Citation

Reddymasu, Savio C., and Richard W. McCallum. "Small Intestinal Bacterial Overgrowth in Gastroparesis: Are There Any Predictors?" Journal of Clinical Gastroenterology, vol. 44, no. 1, 2010, pp. e8-13.
Reddymasu SC, McCallum RW. Small intestinal bacterial overgrowth in gastroparesis: are there any predictors? J Clin Gastroenterol. 2010;44(1):e8-13.
Reddymasu, S. C., & McCallum, R. W. (2010). Small intestinal bacterial overgrowth in gastroparesis: are there any predictors? Journal of Clinical Gastroenterology, 44(1), pp. e8-13. doi:10.1097/MCG.0b013e3181aec746.
Reddymasu SC, McCallum RW. Small Intestinal Bacterial Overgrowth in Gastroparesis: Are There Any Predictors. J Clin Gastroenterol. 2010;44(1):e8-13. PubMed PMID: 20027008.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small intestinal bacterial overgrowth in gastroparesis: are there any predictors? AU - Reddymasu,Savio C, AU - McCallum,Richard W, PY - 2009/12/23/entrez PY - 2009/12/23/pubmed PY - 2010/3/20/medline SP - e8 EP - 13 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 44 IS - 1 N2 - BACKGROUND: There is some degree of overlap in the symptomatic spectrum of patients with gastroparesis and small intestinal bacterial overgrowth (SIBO) and some of the etiologies for gastroparesis, such as diabetes mellitus and vagotomy are known to predispose to SIBO. The aims of our study were to measure the prevalence of SIBO in a cohort of gastroparetic patients with prominence of abdominal pain and bloating and try to identify predictors with regard to demographics, concurrent use of medications such as prokinetics, proton pump inhibitors, and opiate analgesics, and predominant bowel movement abnormality. METHODS: Glucose breath testing (GBT) for SIBO was performed in 50 patients (41 females) with gastroparesis. Demographic data, medication profiles, baseline and peak measurements of hydrogen or methane gas on the GBT, and results of the most recent gastric emptying scintigraphy test were recorded. RESULTS: Thirty of fifty (60%) patients had a positive GBT for SIBO on the basis of hydrogen (63%), methane (27%), or both criteria (10%). SIBO was more likely (P=0.001) in patients with gastroparetic symptoms of greater duration (mean 5 y; 95% CI: 4-6 y). No significant differences were noted in both groups with regard to age, sex, or etiology of gastroparesis. Gastric emptying was similar in the SIBO and non-SIBO group (P>0.05). After adjusting for tegaserod and opiate analgesic use, 14/23 (61%) had a positive GBT. CONCLUSIONS: SIBO is very common in gastroparetics with predominance of abdominal pain and bloating, especially those with a longer duration of gastroparesis. Awareness of SIBO in the setting of gastroparesis will facilitate separation of the 2 entities and allow appropriate therapies to be instituted. SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/20027008/Small_intestinal_bacterial_overgrowth_in_gastroparesis:_are_there_any_predictors L2 - http://Insights.ovid.com/pubmed?pmid=20027008 DB - PRIME DP - Unbound Medicine ER -