High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal

Abstract

This study showed that SIBO affects most celiacs with persistence of GI symptoms after gluten withdrawal.

Breath test for differential diagnosis between small intestinal bacterial overgrowth and irritable bowel disease: An observation on non-absorbable antibiotics

“…Our data confirm other reports in the most recent literature: at the dose of 800 mg for four weeks rifaximin significantly reduced the symptoms in 20 patients with IBS and led to a negative "breath test" in almost half of patients [49] ; in another series of 23 patients with SIBO and positive "breath test", a treatment with rifaximin 1200 mg/d for 7 d followed by a treatment with probiotics, led to a negative "breath test" in 19 (82.6%) cases and significantly reduced the peak in hydrogen concentrations in the expired air from 40.9 ± 20.4 to 4.78 ± 8.42 ppm [12] . More evidence on the efficacy of rifaximin has been reported in patients with SIBO and acute diverticulitis of the colon [50] , and patients with SIBO and celiac disease [51] . It should be noted that further treatment with ciprofloxacin -an antibiotic widely used in the treatment of IBS [52,53] has not given significantly better results than rifaximin in our experience.…”

Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: Experience with Rifaximin

“…Moreover, in another series of 23 patients with SIBO and positive BT, administration of Rifaximin 1200 mg/d for 7 d followed by treatment with probiotics led to a negative BT in 19 (82.6%) cases and significantly reduced the peak in hydrogen concentrations in the expired air from 40.9 ± 20.4 to 4.78 ± 8.42 ppm [2] ; Rifaximin was also more effective than chlortetracycline in improving symptoms in patients with SIBO and IBS [18] . More evidences on the efficacy of Rifaximin have been reported in patients with SIBO and acute diverticulitis of colon [19] , and patients with SIBO and celiac disease [20] . In this study, 48% of patients treated with Rifaximin failed to achieve a clinical benefit and turn the BTLact to negative.…”

Celiac disease in Brazilian patients: associations, complications and causes of death. Forty years of clinical experience

“…The persistence of gastrointestinal symptoms after gluten withdrawal and strict adherence to a GFD (IgA EmA negative) was observed in one female (63 years old) that improved after the use of antibiotics, suggesting the diagnosis of small intestinal bacterial overgrowth (66) .…”