Sobrecrecimiento bacteriano intestinal en pacientes con pancreatitis crónica

Abstract

Small intestine bacterial overgrowth in patients with chronic pancreatitis Background: Previous reports describe 30-40% of small intestine bacterial overgrowth (SIBO) in patients with chronic pancreatitis (CP), SIBO is a cause of persistent symptoms in this group of patients even when they are treated with pancreatic enzymes. Aim: To asses the frequency of SIBO in patients with CP. Patients and methods: We studied 14 patients with CP using an hydrogen breath test with lactulose to detect SIBO, a nonabsorbable carbohydrate, whose results are not influenced by the presence of exocrine insufficiency. Main symptoms and signs were bloating in 9 (64%), recurrent abdominal pain in 8 (57%), intermittent diarrhea in 5 (36%) and steatorrhea in 5 (36%). At the same time we studied a healthy control group paired by age and sex. Results: SIBO was present in 13 of 14 patients with CP (92%) and in 1 of 14 controls (p<0.001). The only patient with CP and without SIBO was recently diagnosed and had minimal morphologic alterations in computed tomography and endoscopic pancreatography. Conclusions: SIBO is common in CP and may be responsible for persistent symptoms. Proper diagnosis and treatment could alleviate symptoms and improve quality of life (Rev Méd Chile 2008; 136: 976-80).

Sbbos and Peptic Ulcer Disease: Epidemiology, Pathogenesis, Influence on Clinical Manifestations and Therapeutic Approaches

“…■ Хронические заболевания печени в стадии цирроза с нарушением внешнесекреторной функции (нарушение желчеобразования) и хронические заболевания поджелудочной железы с внешнесекреторной недостаточностью. Эти функциональные расстройства изменяют среду обитания и способствуют миграции микробной флоры в верхние отделы тонкой кишки [3,[7][8][9]. ■ Функциональная или органическая несостоятельность илеоцекального клапана (воспалительные, опухолевые процессы, ослабляющие, снижающие барьер для транслокации толстокишечной флоры в дистальные отделы тонкой кишки) [1,4].…”

Small Intestinal Bacterial Overgrowth Is Common in Chronic Pancreatitis and Associates With Diabetes, Chronic Pancreatitis Severity, Low Zinc Levels, and Opiate Use

“…This method, however, is invasive (requires endoscopy), costly and is hampered by sampling error, reproducibility and standardization and frequently is not used [27,28]. By hydrogen breath testing (HBT) the prevalence of SIBO in CP is 0-92% [29][30][31][32][33][34][35][36][37][38][39], highest (47-92%) with lactulose hydrogen breath tests (LBT) [33,36,37,39], which lack specificity [27,40,41], and lower (0-40%) with glucose breath tests (GBT) [29][30][31][32]34,35,38], which are more specific. As pointed out in a recent meta-analysis [42], pooled analyses of these data is limited by heterogeneity of the HBT protocol, variable inclusion of patients with prior upper GI surgery, small sample sizes and criteria for diagnosis of definite CP.…”