Small Bowel Bacterial Overgrowth Associated with Persistence of Abdominal Symptoms in Children Treated with a Proton Pump Inhibitor

Sieczkowska, Agnieszka; Landowski, Piotr; Zagożdżon, Paweł; Kamińska, Barbara; Lifschitz, Carlos

doi:10.1016/j.jpeds.2015.01.004

Cited by 34 publications

(34 citation statements)

References 12 publications

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“…We found a high rate of symptomatic patients with SIBO (63.8% -23/36 cases) among children with GERD treated with PPI, strengthening the conclusion of Sieczkowska et al 16 that symptomatic children taking PPI treatment should be tested for SIBO. Hegar et al 17 studied the incidence of positive GHBT in a lot of children treated for one month with omeprazole and probiotics Lactobacillus rhamnosus R0011 and Lactobacillus acidophillus R0052 versus a group treated with omeprazole and placebo.…”

Section: Discussionsupporting

confidence: 85%

“…SIBO was detected in 5/56 (8.9%) PPI using group versus 1/27 (3.7%) control group (P = 0.359), with a relative risk of 2.4 in the above cited study. 15 Sieczkowska et al 16 also obtained a lower rate of intestinal dysbiosis (22.5% of 40 subjects treated for 3 months with PPI), compared to our results. Overall, from 128 children with GERD enrolled in our study and treated for 3 months with PPI (with or without associated probiotics), we found SIBO in 31.2 % of cases (40/128 children) versus 5.0% (6/120 controls) (P < 0.001; RR, 1.38; 95% CI, 1.22-1.56).…”

Section: Discussionsupporting

confidence: 55%

“…Overall, from 128 children with GERD enrolled in our study and treated for 3 months with PPI (with or without associated probiotics), we found SIBO in 31.2 % of cases (40/128 children) versus 5.0% (6/120 controls) (P < 0.001; RR, 1.38; 95% CI, 1.22-1.56). Sieczkowska et al 16 reported that children with intestinal dysbiosis had higher prevalence of GI symptoms than those without SIBO, and the authors concluded that symptomatic patients undergoing PPI treatment should be evaluated for SIBO rather than empirically prolonging antisecretory therapy. A positive GHBT is highly suggestive for diagnosis of SIBO, but it is not always accompanied by the presence on intestinal symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Is It Useful to Administer Probiotics Together With Proton Pump Inhibitors in Children With Gastroesophageal Reflux?

Belei

Olariu

Dobrescu

et al. 2018

J Neurogastroenterol Motil

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Background/Aims Gastroesophageal reflux disease (GERD) is a frequent condition diagnosed in children and treated with proton pump inhibitors (PPI). Long-term PPI administration can alter intestinal bacterial population by suppressing the gastric acid barrier and may cause diarrhea. The aim of this study is to evaluate the prevalence of small intestinal bacterial overgrowth assessed by glucose hydrogen breath test among children that received 12 weeks of PPI with or without probiotics ( Lactobacillus reuteri DSM 17938) associated, compared to controls. Methods Glucose hydrogen breath test was performed before PPI treatment and after 12 weeks of PPI treatment to 128 consecutive children with GERD (1–18 years old) and a control group (120 healthy children). The children with GERD were randomized into 2 groups: placebo group (64 who received PPI and placebo for 12 weeks) and probiotics group (64 who received PPI and probiotics for 12 weeks). Results After 12 weeks of treatment, dysbiosis was detected among 56.2% of children from placebo group (36/64), compared to 6.2% of children from the probiotics group (4/64, P < 0.001). Bacterial overgrowth was detected in 5% of controls (6/120). Probiotics group had a lower prevalence of dysbiosis, similar to controls ( P = 0.740). Conclusion Probiotics administration decreased the rate of dysbiosis among children treated with PPI.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is It Useful to Administer Probiotics Together With Proton Pump Inhibitors in Children With Gastroesophageal Reflux?

Belei

Olariu

Dobrescu

et al. 2018

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…When growth was detected, organisms in the colonies were counted and identified by standard methods. A total bacteria count of ≥10 5 /mL was considered positive for bacterial overgrowth, as previously reported as the definition of SIBO ( 13 - 15 ).…”

Section: Methodsmentioning

confidence: 99%

Superior Mesenteric Artery Syndrome May Be Overlooked in Women with Functional Dyspepsia

et al. 2017

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Objective Superior mesenteric artery (SMA) syndrome is characterized by the compression of the third segment of the duodenum between the SMA and aorta, resulting in duodenal obstruction. Because the symptoms of the syndrome are similar to those of functional dyspepsia (FD), this study aimed to examine whether or not patients with SMA syndrome were present among those diagnosed with FD. Methods Patients with an FD diagnosis underwent measurement of the angle and distance between the SMA and aorta by ultrasonography or computed tomography. Patients with an angle of ≤22° or with a distance of ≤8 mm between the SMA and aorta were diagnosed with SMA syndrome. Bacterial culture of the duodenal aspirate was also performed. Results Of the 46 FD patients, 5 (11%) met the criteria. All 5 were women with a body mass index significantly lower than the remaining 41 patients (18.7 vs. 24.0 kg/m2, p=0.003). In addition, all 5 patients had 105/mL or more bacteria in the duodenum. The symptoms of these five patients were treated through dietary and postprandial posture counselling with or without medication. Conclusion Patients with SMA syndrome were observed among underweight women diagnosed with FD. Their symptoms may be associated with bacterial overgrowth.

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“…Nasal microvasculature and paranasal sinuses play an integral role in maintaining health. Dysbiosis is a possible cause of chronic rhinosinusitis and other upper respiratory tract diseases [21]. Alterations to the microbiome, local changes in mucus secretion and inflammation may predispose children to upper respiratory tract infections [9].…”

Section: Otitis Media and Upper Respiratory Tract Infectionsmentioning

confidence: 99%

Possible Effects of Proton Pump Inhibitors on Hearing Loss Development

Wiciński

Malinowski

Puk

et al. 2019

BioMed Research International

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For their being considered safe and as over-the-counter (OTC) drugs, proton pump inhibitors (PPI) are one of the most frequently used medicines nowadays. However, for the last couple of years, many researches analyzing PPI were conducted and these studies shed light on PPI side effects and mechanisms of these processes. Particularly, interesting is the impact of PPI on hearing loss development. However, this side effect seems to be local and its mechanisms are complex and systemic and involve changes in the whole body. This paper summarizes how through, inter alia, alterations in circulatory system, respiratory system, central nervous system, and metabolic changes PPI can cause hearing impairment, which can occur at every age and is connected with long-term use of this group of drugs. Another important finding is the role of PPI in acceleration of presbycusis development which is disturbing with regard to the fact that elders are the group who most frequently use PPI in the long term. Hearing loss is the factor which gravely decreases life quality, especially among elders who are the most afflicted group; thus, administration of PPI should be considered carefully, taking under consideration all benefits and all potential side effects.

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Small Bowel Bacterial Overgrowth Associated with Persistence of Abdominal Symptoms in Children Treated with a Proton Pump Inhibitor

Cited by 34 publications

References 12 publications

Is It Useful to Administer Probiotics Together With Proton Pump Inhibitors in Children With Gastroesophageal Reflux?

Is It Useful to Administer Probiotics Together With Proton Pump Inhibitors in Children With Gastroesophageal Reflux?

Superior Mesenteric Artery Syndrome May Be Overlooked in Women with Functional Dyspepsia

Possible Effects of Proton Pump Inhibitors on Hearing Loss Development

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