Importance of anaerobic bacteria in the cobalamin malabsorption of the experimental rat blind loop syndrome

Welkos, Susan L.; Toskes, Phillip P.; Baer, Herman; Smith, George W.

doi:10.1016/0016-5085(81)90720-4

Cited by 63 publications

(23 citation statements)

References 14 publications

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“…Moreover, bacterial overgrowth with anaerobic bacteria may lead to BI2 malabsorption (20). However, we did not find this to be a plausible explanation of the Blr malabsorption observed in five patients investigated for bacterial overgrowth in the proximal small intestine.…”

Section: Discussionmentioning

confidence: 85%

Giardiasis: haematological status and the absorption of vitamin B₁₂ and folic acid

1992

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The haematological status, as well as the fractional absorptions of folic acid (FAFol) and vitamin B12 (FAB12) were studied in 29 children aged 0.7-13.5 years (mean 3.3 years) with chronic diarrhoea due to giardiasis. Small intestinal biopsies revealed mucosal damage in 20 children; the biopsies of the remaining nine children were normal. At the initial investigation the FAFol and FAB12 values were below normal in approximately one-sixth and one-third of patients, respectively. Bacterial overgrowth of the small intestinal tract did not seem to play a role in FAB12 malabsorption. About one-fifth of patients had mild anaemia. None of the patients showed FAB12 insufficiency and only one patient suffered from folate depletion. At follow-up, FAFol, FAB12, haemoglobin and Erc-folate concentrations increased significantly while P-B12 and P-folate remained unchanged. Iron status, as well as dietary intake of iron, appeared insufficient prior to, as well as after treatment. Serum iron, transferrin saturation and haemoglobin concentrations were lower in patients who had acquired the disease abroad or suffered from persistent diarrhoea.

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Section: Discussionmentioning

confidence: 85%

Giardiasis: haematological status and the absorption of vitamin B₁₂ and folic acid

1992

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“…However, in SBBO, various anaerobic and facultative gram-negative aerobes competitively utilize dietary cobalamin. Intrinsic factor inhibits cobalamin utilization by aerobic bacteria but has no effect on the ability of gram-negative anaerobic flora to take up dietary cobalamin [19]. Although enteric bacteria also synthesize some cobalamin, they retain this vitamin, and thus it remains unavailable to the host for absorption.…”

Section: Mechanisms Of Malabsorptionmentioning

confidence: 96%

Small bowel bacterial overgrowth: Presentation, diagnosis, and treatment

Singh

Toskes

2003

Curr Gastroenterol Rep

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Small bowel bacterial overgrowth (SBBO) syndrome is associated with excessive numbers of bacteria in the proximal small intestine. The pathology of this condition involves competition between the bacteria and the human host for ingested nutrients. This competition leads to intraluminal bacterial catabolism of nutrients, often with production of toxic metabolites and injury to the enterocyte. A complex array of clinical symptoms ensues, resulting in chronic diarrhea, steatorrhea, macrocytic anemia, weight loss, and less commonly, protein-losing enteropathy. Therapy is targeted at correction of underlying small bowel abnormalities that predispose to SBBO and appropriate antibiotic therapy. The symptoms and signs of SBBO can be reversed with this approach.

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“…As a rule, patients evolve with secondary megaloblastic anemia caused by vitamin B12 deficiency [7]. In the present cases, we observed that despite hemoglobin improvement after antibiotic therapy, increased average corpuscle volume also occurred, associated to a lowering of vitamin B12 serum levels.…”

Section: Discussionmentioning

confidence: 89%

“…In the present cases, we observed that despite hemoglobin improvement after antibiotic therapy, increased average corpuscle volume also occurred, associated to a lowering of vitamin B12 serum levels. Fobi-Capella gastroplasty can also contribute to the appearance of this type of anemia, rendering it necessary to supplement B12 vitamin to most bariatric surgery patients [7,8]. One of our patients presented increased serum levels of folic acid, which may be explained by increased folate production by small intestine bacteria [9].…”

Section: Discussionmentioning

confidence: 99%

Intestinal Bacterial Overgrowth After Roux-en-Y Gastric Bypass

et al. 2007

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The aim of the present study was to report the occurrence of serious subnutrition, associated to intestinal bacterial overgrowth, in two patients submitted to bariatric surgery. Two female patients (body mass index, 49 and 50 kg/m(2), respectively) were submitted to Y-en-Roux gastric bypass. The first patient evolved a 52% loss of body weight within 21 months after surgery; the other, a 34% loss of initial body weight within 15 months after surgery, results corresponding, respectively, to 62 and 45 kg weight losses. However, both patients reported asthenia, hair fallout, and edema, and one also reported diarrhea, but none was feverish. Their respective albuminemias were of 24 and 23 g/l. A respiratory hydrogen test suggested bacterial hyperproliferation. Thirty days after ciprofloxacin and tetracyclin treatments, they showed improved albumin levels and nutritional states, both confirmed by results of hydrogen breath tests. Bacterial overgrowth is an important complication that can compromise clinical evolution of patients submitted to intestinal surgery like gastroplasty with Y-Roux anastomosis. In cases of clinical suspicion or a confirmed diagnosis, adequate antibiotics, sometimes requiring to be cyclically repeated, should be administered.

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Importance of anaerobic bacteria in the cobalamin malabsorption of the experimental rat blind loop syndrome

Cited by 63 publications

References 14 publications

Giardiasis: haematological status and the absorption of vitamin B₁₂ and folic acid

Giardiasis: haematological status and the absorption of vitamin B₁₂ and folic acid

Small bowel bacterial overgrowth: Presentation, diagnosis, and treatment

Intestinal Bacterial Overgrowth After Roux-en-Y Gastric Bypass

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Importance of anaerobic bacteria in the cobalamin malabsorption of the experimental rat blind loop syndrome

Cited by 63 publications

References 14 publications

Giardiasis: haematological status and the absorption of vitamin B12 and folic acid

Giardiasis: haematological status and the absorption of vitamin B12 and folic acid

Small bowel bacterial overgrowth: Presentation, diagnosis, and treatment

Intestinal Bacterial Overgrowth After Roux-en-Y Gastric Bypass

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Product

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Giardiasis: haematological status and the absorption of vitamin B₁₂ and folic acid

Giardiasis: haematological status and the absorption of vitamin B₁₂ and folic acid