Small intestinal bacterial overgrowth (SIBO) is characterized by nutrient malabsorption, associated with an excessive number of bacteria in the proximal
ARTÍCULO DE REVISIÓNCorrespondencia a: Dr. Rodrigo Quera P. Sección de Gastroenterología, Hospital Clínico de la Universidad de Chile. Santos Dumont 999, Independencia, Santiago. Telé-fono: 6788350. E mail: rodrigoquera@yahoo.es L a microflora gastrointestinal humana es un complejo ecosistema de aproximadamente 500 especies bacterianas que colonizan el tracto alimentario poco después del nacimiento y que mantienen su composición relativamente constante a través de la vida 1 . Normalmente, sólo un pequeño número es encontrado en el intestino delgado al compararlos con los existentes en el colon. Dado que la flora bacteriana es excluida del intestino delgado, se evita su competencia con el hospedero en el sitio de digestión y absorción de alimentos. Cultivos de contenido yeyunal pueden no detectar bacterias hasta en 33% de los sujetos sanos. Cuando las bacterias están presentes, ellas son usualmente lactobacillus, enterococo, estreptococo, y otras bacterias aeróbicas gram (+) o anaerobios facultativos. El recuento bacteriano raramente supera las 10 4 unidades formadoras de colonias (UFC). La microbiología del íleon terminal representa una área de transición entre la escasez de bacterias en el yeyuno, principalmente especies aeróbicas, y la densa población de bacterias anaeróbicas encontradas en el colon. El
Background: Esophageal candidiasis is associated with conditions that cause an immune depression. It is a defining disease for AIDS, is observed in poorly con (Rev Méd Chile 2004; 132: 1389-94).
Small intestine bacterial overgrowth in patients with chronic pancreatitis Background: Previous reports describe 30-40% of small intestine bacterial overgrowth (SIBO) in patients with chronic pancreatitis (CP), SIBO is a cause of persistent symptoms in this group of patients even when they are treated with pancreatic enzymes. Aim: To asses the frequency of SIBO in patients with CP. Patients and methods: We studied 14 patients with CP using an hydrogen breath test with lactulose to detect SIBO, a nonabsorbable carbohydrate, whose results are not influenced by the presence of exocrine insufficiency. Main symptoms and signs were bloating in 9 (64%), recurrent abdominal pain in 8 (57%), intermittent diarrhea in 5 (36%) and steatorrhea in 5 (36%). At the same time we studied a healthy control group paired by age and sex. Results: SIBO was present in 13 of 14 patients with CP (92%) and in 1 of 14 controls (p<0.001). The only patient with CP and without SIBO was recently diagnosed and had minimal morphologic alterations in computed tomography and endoscopic pancreatography. Conclusions: SIBO is common in CP and may be responsible for persistent symptoms. Proper diagnosis and treatment could alleviate symptoms and improve quality of life (Rev Méd Chile 2008; 136: 976-80).
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