Delayed Gastric Emptying Is Not Associated with a Microbiological Diagnosis of Small Intestinal Bacterial Overgrowth

Calderón, Gerardo; Siwiec, Robert M.; Bohm, Matthew; Nowak, Thomas; Wo, John M.; Gupta, Anita; Xu, Huiping; Shin, Andrea

doi:10.1007/s10620-020-06153-1

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…Similar to earlier studies in patients with diabetic and idiopathic gastroparesis 12 and other gastrointestinal disorders, 29 SIBO was not associated with more severe daily symptoms, perhaps because patients with diabetic gastroparesis limit their intake of calories and fats. 44 Alternatively, or in addition, bacterial cultures may not be the optimal method for characterizing dysbiosis.…”

Section: Discussionsupporting

confidence: 83%

“…Neither of these studies compared the prevalence of SIBO in DM patients with versus without delayed GE. Among 73 patients with delayed GE including 22% with DM, 44 had no overgrowth (60%), 14 had SIBO (20%), and 15 had colonic‐type SIBO (20%) 12 . Gastrointestinal symptoms assessed with the Gastroparesis Cardinal Symptom Index (GCSI) diary were not different among the groups.…”

Section: Introductionmentioning

confidence: 99%

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Small intestinal bacterial overgrowth in diabetic gastroenteropathy

Varma,

Chakraborty,

Burton

et al. 2024

Neurogastroenterology Motil

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BackgroundAlthough diabetic gastroenteropathy (DGE) is associated with small intestinal bacterial overgrowth (SIBO), most studies have evaluated SIBO with a hydrogen breath test, which may be affected by altered transit in DGE. The risk factors for the consequences of SIBO in DGE are poorly understood. We aimed to evaluate the prevalence of, risk factors for, and gastrointestinal symptoms associated with SIBO in patients with DGE.MethodsIn 75 patients with DGE and dyspepsia, we tested for SIBO (≥105 colony forming units /mL of aerobic and/or anaerobic bacteria in a duodenal aspirate) and assessed gastric emptying (GE) of solids, symptoms during a GE study and during an enteral lipid challenge (300 kcal/2 h), and daily symptoms with a Gastroparesis Cardinal Symptom Index diary for 2 weeks. Symptoms and GE were compared in patients with versus without SIBO.Key ResultsOf 75 patients, 34 (45%) had SIBO, which was not associated with the use of proton pump inhibitors, daily symptoms, GE, or symptoms during a GE study. During enteral lipid challenge, severe nausea (p = 0.006), fullness (p = 0.02) and bloating (p = 0.009) were each associated with SIBO. Twenty patients (59%) with versus 13 (32%) without SIBO had at least one severe symptom during the lipid challenge (p = 0.006).Conclusions & InferencesAmong patients with DGE 45% had SIBO, which was associated with symptoms during enteral lipid challenge but not with delayed GE, symptoms during a GE study, or daily symptoms. Perhaps bacterial products and even fatty acids are recognized by and activate mast cells that drive the increased lipid sensitivity in SIBO.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Small intestinal bacterial overgrowth in diabetic gastroenteropathy

Varma,

Chakraborty,

Burton

et al. 2024

Neurogastroenterology Motil

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“…Ileocecal junction pressure was lower, small bowel, colonic, and whole gut transit times were longer, and gastric and small bowel pH was higher in patients with SIBO than in those without[ 13 , 14 ]. There were no significant differences in gastric emptying time and other small intestinal motility parameters (small intestinal motility index, contractions per minute, and peak amplitudes)[ 13 , 15 ], or in fecal calprotectin levels[ 16 ]. SIBO was more frequent in patients who consumed a moderate amount of alcohol than in abstainers (58% vs 39%)[ 17 ].…”

Section: Patients With Gastroenterological Complaintsmentioning

confidence: 99%

Epidemiology of small intestinal bacterial overgrowth

Efremova,

Maslennikov,

Poluektova

et al. 2023

World J Gastroenterol

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Small intestinal bacterial overgrowth (SIBO) is defined as an increase in the bacterial content of the small intestine above normal values. The presence of SIBO is detected in 33.8% of patients with gastroenterological complaints who underwent a breath test, and is significantly associated with smoking, bloating, abdominal pain, and anemia. Proton pump inhibitor therapy is a significant risk factor for SIBO. The risk of SIBO increases with age and does not depend on gender or race. SIBO complicates the course of a number of diseases and may be of pathogenetic significance in the development of their symptoms. SIBO is significantly associated with functional dyspepsia, irritable bowel syndrome, functional abdominal bloating, functional constipation, functional diarrhea, short bowel syndrome, chronic intestinal pseudo-obstruction, lactase deficiency, diverticular and celiac diseases, ulcerative colitis, Crohn’s disease, cirrhosis, metabolic-associated fatty liver disease (MAFLD), primary biliary cholangitis, gastroparesis, pancreatitis, cystic fibrosis, gallstone disease, diabetes, hypothyroidism, hyperlipidemia, acromegaly, multiple sclerosis, autism, Parkinson’s disease, systemic sclerosis, spondylarthropathy, fibromyalgia, asthma, heart failure, and other diseases. The development of SIBO is often associated with a slowdown in orocecal transit time that decreases the normal clearance of bacteria from the small intestine. The slowdown of this transit may be due to motor dysfunction of the intestine in diseases of the gut, autonomic diabetic polyneuropathy, and portal hypertension, or a decrease in the motor-stimulating influence of thyroid hormones. In a number of diseases, including cirrhosis, MAFLD, diabetes, and pancreatitis, an association was found between disease severity and the presence of SIBO. Further work on the effect of SIBO eradication on the condition and prognosis of patients with various diseases is required.

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“…Remarkably, no significant association was found between SIBO diagnoses and delayed gastric emptying when using scintigraphy. The authors concluded that the microbiological diagnosis of SIBO is not associated with gastric emptying [ 51 ].…”

Section: Microbiota and Gastroparesismentioning

confidence: 99%

Gastroparesis: The Complex Interplay with Microbiota and the Role of Exogenous Infections in the Pathogenesis of the Disease

et al. 2023

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Gastroparesis (GP) is a disorder of gastric functions that is defined by objective delayed gastric emptying in the absence of mechanical obstruction. This disease is characterized by symptoms such as nausea, post-prandial fullness, and early satiety. GP significantly impacts patients’ quality of life and contributes to substantial healthcare expenses for families and society. However, the epidemiological burden of GP is difficult to evaluate, mainly due its significant overlap with functional dyspepsia (FD). GP and FD represent two similar diseases. The pathophysiology of both disorders involves abnormal gastric motility, visceral hypersensitivity, and mucosal inflammation. Moreover, both conditions share similar symptoms, such as epigastric pain, bloating, and early satiety. The latest evidence reveals that dysbiosis is directly or indirectly connected to gut–brain axis alterations, which are the basis of pathogenesis in both FD and GP. Furthermore, the role of microbiota in the development of gastroparesis was demonstrated by some clinical studies, which found that the use of probiotics is correlated with improvements in the gastric emptying time (GET). Infections (with viruses, bacteria, and protozoa) represent a proven etiology for GP but have not been sufficiently considered in current clinical practice. Previous viral infections can be found in about 20% of idiopathic GP cases. Moreover, delayed gastric emptying during systemic protozoal infections represents a huge concern for compromised patients, and few data exist on the topic. This comprehensive narrative review analyzes the relationship between microorganisms and GP. We explore, on the one hand, the correlation between gut microbiota dysbiosis and GP pathogenesis, including treatment implications, and, on the other hand, the association between exogenous infections and the etiology of the disease.

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Delayed Gastric Emptying Is Not Associated with a Microbiological Diagnosis of Small Intestinal Bacterial Overgrowth

Cited by 4 publications

References 27 publications

Small intestinal bacterial overgrowth in diabetic gastroenteropathy

Small intestinal bacterial overgrowth in diabetic gastroenteropathy

Epidemiology of small intestinal bacterial overgrowth

Gastroparesis: The Complex Interplay with Microbiota and the Role of Exogenous Infections in the Pathogenesis of the Disease

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