Clinical Presentation of Small Intestinal Bacterial Overgrowth from Aerodigestive Tract Bacteria Versus Colonic-Type Bacteria: A Comparison Study.

Autor: Siddique DA; Internal Medicine, Department of Medicine, Indiana University, Indianapolis, IN, USA., Jansson-Knodell CL; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, IN, USA., Gupta A; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, IN, USA., Howard G; School of Medicine, Indiana University, Indianapolis, IN, USA., Bohm ME; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, IN, USA., Siwiec RM; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, IN, USA., Nelson DE; Microbiology and Immunology, Indiana University, Indianapolis, IN, USA., Shin AS; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, IN, USA., Wo JM; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, IN, USA. jmwo@iu.edu.; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, 550 University Blvd, Suite 1634, Indianapolis, IN, 46202, USA. jmwo@iu.edu.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2023 Aug; Vol. 68 (8), pp. 3390-3399. Date of Electronic Publication: 2023 Jun 15.
DOI: 10.1007/s10620-023-07999-x
Abstrakt: Background: Small Intestinal Bacterial Overgrowth (SIBO) is a heterogenous syndrome from excessive bacteria in the small intestine lumen. It is unknown if differences in type of bacterial overgrowth lead to differences in symptoms.
Methods: Patients with suspected SIBO were recruited prospectively. Exclusion criteria were probiotics, antibiotics, or bowel prep in preceding 30 days. Clinical characteristics, risk factors, and labs were collected. Proximal jejunal aspiration via upper enteroscopy was performed. Aerodigestive tract (ADT) SIBO was defined as > 10 5  CFU/mL of oropharyngeal and respiratory bacteria. Colonic-type SIBO was defined as > 10 4  CFU/mL of distal small bowel and colon bacteria. Aims were to compare symptom profiles, clinical complications, labs, and underlying risk factors between ADT and colonic-type SIBO.
Key Results: We consented 166 subjects. Aspiration was not obtained in 22 and SIBO was found in 69 (49%) of 144 subjects. Daily abdominal distention trended towards more prevalent in ADT SIBO versus colonic-type SIBO (65.2% vs 39.1%, p = 0.09). Patient symptom scores were similar. Iron deficiency was more prevalent in ADT SIBO (33.3% vs 10.3%, p = 0.04). Subjects with colonic-type SIBO were more likely to have a risk factor for colonic bacteria colonization (60.9% vs 17.4%, p = 0.0006). Subjects with ADT SIBO were more likely to have a risk factor for diminished gastric acid (91.3% vs 67.4%, p = 0.02).
Conclusions & Inferences: We found differences in iron deficiency and underlying risk factors between ADT and colonic-type SIBO. However, distinct clinical profiles remained elusive. Future research is needed to develop validated symptom assessment tools and distinguish cause from correlation.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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