Impact of Gastric Acidity on the Acquisition of Cholera Post Gastric Bypass

Bias, Tiffany; Davanos, Evangelia; Rahman, Shafiqur; Venugopalan, Veena

doi:10.1089/bari.2013.9977

Cited by 1 publication

(2 citation statements)

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“…Reduced stomach acid has been proposed as a possible risk factor for both epidemic and non-epidemic V. cholerae infection due to the loss of protection conferred by normal gastric acid levels [22–26]. Our patient was on chronic omeprazole and also had Roux-en-Y gastric bypass surgery which has been associated with decreased basal and peak production of gastric acid [27] She also had a history of untreated H.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, no antibiotic resistance genes were identified using ResFinder [15] Virulence addition to pathogen virulence factors, host susceptibility to infection is necessary to result in clinical disease. Reduced stomach acid has been proposed as a possible risk factor for both epidemic and non-epidemic V. cholerae infection due to the loss of protection conferred by normal gastric acid levels [22][23][24][25][26]. Our patient was on chronic omeprazole and also had Roux-en-Y gastric bypass surgery which has been associated with decreased basal and peak production of gastric acid [27] She also had a history of untreated H. pylori which has been associated with an increased risk of cholera infection [28], possibly due to the induction of hypochlorhydria [29,30].…”

Section: Discussionmentioning

confidence: 99%

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Duped by dumping syndrome: non-endemic Vibrio cholerae bacteremia in an immunocompetent host with gastric bypass surgery, a case report

Reyes,

Pecora,

Weiss

2023

Access Microbiology

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Extra-intestinal infection with non-O1/non-O139 strains of Vibrio cholerae (NOVC) is rare, though bacteremia and hepatobiliary manifestations have been reported. Reduced stomach acid, or hypochlorhydria, can increase risk of V. cholerae infection. We describe a 42-year-old woman with hypochlorhydria due to untreated Helicobacter pylori infection, gastric-bypass surgery, and chronic proton pump inhibitors (PPI) exposure, who developed acute diarrhoea following raw oyster consumption. Her symptoms were attributed to rapid gastric emptying (dumping syndrome) after a negative limited stool work-up. She had persistent diarrhoea, weight loss, and after 5 months was admitted with acute cholecystitis and NOVC bacteremia, requiring cholecystectomy. This is the first reported case of NOVC bacteremia and cholecystitis in a patient with gastric bypass. This case highlights the potential for NOVC biliary carriage, the role of hypochlorhydria as a risk factor for Vibrio infection, and the importance of excluding infectious diarrhoea in patients with new onset of symptoms compatible with dumping syndrome and a relevant travel history.

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