When treatment was effective, the impact on malnutrition was negligible and may have been associated with other factors.
Rifaximin and metronidazole were found to be largely ineffective in eradicating SIBO. No correlation was found with any malnutrition parameter. SIBO was identified in 61.6% of patients after gastrectomy. No statistically significant changes were found in nutritional parameters after treatment. The rate of total antibiotic treatment failure was 67.6%. After treatment with rifaximin, 94.6% of patients were still positive for SIBO, which fell to 85.7% after metronidazole. SIBO patients tended to have a lower BMI, although this trend was not statistically significant. A sub-analysis of the curve was performed at 45 min to minimise possible false positives, and SIBO was identified in 61.6% of cases. Sixty gastrectomy patients were analysed, 58.3% of which were male. The antibiotic regimens and the number of treatment lines used were assessed. Demographic variables and nutritional parameters were collected at baseline and one month after effective treatment of SIBO. A hydrogen-methane breath test with oral glucose overload was performed. Material and methodsĪ prospective cohort study was performed at the Agencia Sanitaria Costa del Sol (Costa del Sol Health Agency) from 2012 to 2015. To describe the antibiotic treatment required to correct it and if nutritional status improves.
To evaluate the prevalence of SIBO after gastrectomy and its association with malnutrition. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.Available evidence assessing the impact of small intestinal bacterial overgrowth (SIBO) following gastrectomy is limited. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. This is particularly important when the recommended agent is a new and/or infrequently employed drug.ĭisclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.ĭrug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. Current SIBO treatment is based on empirical courses of broad-spectrum antibiotics since few controlled studies concerning the choice and duration of antibiotic therapy are available at present.Ĭopyright: All rights reserved. Antibiotic therapy is the cornerstone of SIBO treatment. Breath tests (glucose and/or lactulose breath tests) have been proposed as a sensitive and simple tool for the diagnosis of bacterial overgrowth, being non-invasive and inexpensive compared to the gold standard represented by the culture of intestinal aspirates. Diarrhea, steatorrhea, chronic abdominal pain, bloating and flatulence are common symptoms and are similar to those observed in irritable bowel syndrome. When these mechanisms fail, bacterial overgrowth develops. The main mechanisms restricting bacterial colonization in the upper gut are the gastric acid barrier, mucosal and systemic immunity and intestinal clearance. Small intestinal bacterial overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine.