Small bowel bacterial overgrowth: A negative factor in gut adaptation in pediatric SBS

Cole, Conrad R.; Ziegler, Thomas R.

doi:10.1007/s11894-007-0059-3

Cited by 71 publications

(47 citation statements)

References 53 publications

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“…2 Additionally, overgrowth of such organisms is associated negatively with bowel adaptation. 23 The fact that these organisms became less prominent in our study is somewhat unexpected, but the possibility exists that a 50 % SBR is insufficient to induce such changes, as these mice neither develop dilated loops of bowel nor require parenteral nutrition for survival.…”

Section: Discussionmentioning

confidence: 60%

Small Bowel Resection Induces Long-Term Changes in the Enteric Microbiota of Mice

Sommovilla

Zhou

Sun

et al. 2015

Journal of Gastrointestinal Surgery

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Purpose The enteric microbiome is known to play a major role in healthy gut homeostasis and several disease states. It may also contribute to both the intestinal recovery and complications that occur in patients with short bowel syndrome. The extent and nature of alterations to the gut microbiota following intestinal resection, however, are not well studied in a controlled setting. The purpose of this investigation is to characterize the effects of massive small bowel resection on the murine enteric microflora. Methods Wild-type C57BL6 mice, following a week of acclamation to a liquid rodent diet, underwent either 50 % proximal small bowel resection (SBR) or a sham operation. Mice were sacrificed, and enteric contents from the small bowel, cecum, and stool were harvested at 7 and 90 days post-operatively. DNA was isolated, and the V3–V5 regions of the 16s rRNA gene amplified and pyrosequenced on a Roche 454 platform. Sequences were clustered into operation taxonomic units and classified. Communities were then analyzed for diversity and phylogenic composition. Results In the long-term group, the microbes inhabiting the ileum of mice undergoing SBR and sham operation differed significantly at the genus level (p<0.001). Small bowel contents collected before and after SBR also differed significantly (p= 0.006). This was driven by an increase in Lactobacillus and decrease in Enterobacteriaceae species in mice undergoing SBR. No difference was seen in the long-term stool or in stool, cecal, or ileal contents in the short-term. No difference in microbial community diversity was found in any group. Conclusion Bowel resection induces long-term changes in the microbial community of the murine ileum, but not at more distal sites of the gastrointestinal tract. The increase in Lactobacillus encountered small bowel of resected mice correlates with limited previous studies. These changes may reflect an adaptive response of the microbiota to maximize energy extraction, but further studies are needed to establish the role played by this altered community.

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Section: Discussionmentioning

confidence: 60%

Small Bowel Resection Induces Long-Term Changes in the Enteric Microbiota of Mice

Sommovilla

Zhou

Sun

et al. 2015

Journal of Gastrointestinal Surgery

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“…The presence of overgrowth, as detected by the exhaled H 2 test has been described in 0-12.5% in the asymptomatic (20) volunteer group. However, it is important to note that the actual prevalence of the syndrome is not well known due to remaining difficulties for its diagnosis in daily practice (2) .…”

Section: Discussionmentioning

confidence: 99%

“…It is known that although the gold standard for the diagnosis of overgrowth is still the presence of 1 x 10 5 to 10 6 colony forming units/mL (cfu/mL) in the jejunal aspirate, this definition has been challenged in the present scenario (2,5) . Khoshini and collaborators suggest that healthy individuals rarely have higher bacterial counts than 1 x 10 3 cfu/mL, which should be the new threshold for definition of the syndrome (8) .…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Small Intestine Bacterial Overgrowth in Patients With Gastrointestinal Symptoms

Martins

Chaves

Castro

et al. 2017

Arq. Gastroenterol.

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-Background -Small intestine bacterial overgrowth is a heterogeneous syndrome characterized by an increase in the number and/or the presence of atypical microbiota in the small intestine. The symptoms of small intestine bacterial overgrowth are unspecific, encompassing abdominal pain/distension, diarrhea and flatulence. Due to the increased cost and complexity for carrying out the jejunal aspirate, the gold standard for diagnosis of the syndrome, routinely the hydrogen (H 2 ) breath test has been used, utilizing glucose or lactulose as substrate, which is able to determine, in the exhaled air, the H 2 concentration produced from the intestinal bacterial metabolism. However, due to a number of individuals presenting a methanogenic microbiota, which does not produce H 2 , the testing on devices capable of detecting, concurrently, the concentration of exhaled H 2 and methane (CH 4 ) is justified. Objective -This study aimed to determine the prevalence of small intestine bacterial overgrowth in patients with digestive symptoms, through a comparative analysis of breath tests of H 2 or H 2 and CH 4 associated, using glucose as substrate . Methods -A total of 200 patients of both sexes without age limitation were evaluated, being directed to a Breath Test Laboratory for performing the H 2 test (100 patients) and of exhaled H 2 and CH 4 (100 patients) due to gastrointestinal complaints, most of them patients with gastrointestinal functional disorders. Results -The results indicated a significant prevalence of small intestine bacterial overgrowth in the H 2 test and in the test of exhaled H 2 and CH 4 (56% and 64% respectively) in patients with gastrointestinal symptoms, and higher prevalence in females. It found further that methane gas was alone responsible for positivity in 18% of patients. Conclusion -The data found in this study is consistent with the findings of the current literature and underscores the need for using devices capable of capturing the two gases (exhaled H 2 and CH 4 ) to improve the sensitivity and hence the accuracy of small intestine bacterial overgrowth diagnosis in daily medical practice. HEADINGS -Bacterial growth. Small intestine. Breath tests. Hydrogen. Methane.

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“…Studies have demonstrated a shorter duration of the migratin motor complex cycle and feed pattern after resection [26]. Since bowel dilatation is a natural sequel of adaptation, surgery should be deferred unless dilatation causes recurrent episodes of bacteremia [27]. Bowel dilatation occurs more commonly in younger patients, who are more often candidates for surgical rehabilitation than adults [28].…”

Section: Intestinal Adaptationmentioning

confidence: 99%

Surgical Options in Short Bowel Syndrome

Rodríguez-Montes¹

2016

J.Paedi.Care.Inol

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Short bowel syndrome is characterized by a significant reduction in the effective intestinal surface by an anatomical or functional loss of the small intestine. It mainly occurs after extensive bowel resection, intestinal intrinsic disease or surgical bypass. The main complications are mal-digestion, malnutrition, dehydration and, potentially, lethal lesions. The management, based on appropriate and individualized nutritional support, is complexand requires a multidisciplinary approach including dietary, fluid and pharmacological management, co-morbid disease management and, sometimes, surgery. Numerous surgical procedures to relieve the consequences of massive intestinal resection have been devised, but many have not been employed in human clinics and have remained in the experimental surgery field. The choice of technique is dictated by the patient´s underlying pathophysiology and includes such factors as age, intestinal transit time, length of remnant bowel, presence of intact colon, degree of small bowel dilation, and others. Autologous intestinal reconstruction includes various techniques which manipulate the bowel surgically to facilitate the bowel adaptation process and restoration of enteral nutrition. The most accepted techniques are those elongating the bowel that may be applied only on dilated bowel. However, the intestinal transplantation can be a curative alternative for patients in whom intestinal rehabilitation attempts have failed and who are at risk of life-threatening parenteral nutrition complications.

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Small bowel bacterial overgrowth: A negative factor in gut adaptation in pediatric SBS

Cited by 71 publications

References 53 publications

Small Bowel Resection Induces Long-Term Changes in the Enteric Microbiota of Mice

Small Bowel Resection Induces Long-Term Changes in the Enteric Microbiota of Mice

Prevalence of Small Intestine Bacterial Overgrowth in Patients With Gastrointestinal Symptoms

Surgical Options in Short Bowel Syndrome

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