The diagnosis of small bowel bacterial overgrowth

Corazza, Gino Roberto; Menozzi, Maria Grazia; Strocchi, Alessandra; Rasciti, Leonardo; Vaira, Dino; Lecchini, R.; Avanzini, Paola; Chezzi, Carlo; Gasbarrini, Giovanni

doi:10.1016/0016-5085(90)90818-l

Cited by 306 publications

(48 citation statements)

References 30 publications

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“…We chose 20 ppm of H 2 above the baseline as our definition of a positive test in keeping with previous studies [12][13][14]. This is higher than some studies, which have used 12 ppm [11] and 10 ppm [10,15,16]. The exact figure chosen will of course influence the number of positive tests and thus the sensitivity and specificity of the test.…”

Section: Discussionmentioning

confidence: 99%

Small bowel bacterial overgrowth in subjects living in residential care homes

Lewis¹

1999

Age and Ageing

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Objectives: in elderly people, bacterial overgrowth of the small bowel may be occult. The significance of positive breath tests are uncertain: many fit elderly subjects with positive tests show no evidence of malabsorption. We assessed the prevalence and significance of bacterial overgrowth in the small bowel in a relatively unselected elderly population. Methods: residents of seven elderly people's homes had a glucose hydrogen breath test. A medical history and anthropomorphic measurements were recorded. Volunteers with positive breath tests were given doxycycline. After 4 months all volunteers were reassessed. Results: of 140 residents, 62 were tested. Nine (14.5%) had a positive breath test. There was no difference in anthropomorphic and bowel habit data between those with positive and those with negative breath tests. After 4 months of antibiotic treatment, volunteers with a positive breath test had increased weight and body mass index, while those with a negative test had decreased weight and body mass index. Conclusions: the percentage of volunteers with a positive breath test was much lower than in previous studies. This may be due to the relatively unselected nature of the volunteers. Treatment of bacterial overgrowth resulted in a small but significant improvement in anthropometric indices. The lack of association of positive breath tests with baseline anthropomorphic measurements or bowel habit highlights the occult nature of the bacterial overgrowth and questions its clinical importance.

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Section: Discussionmentioning

confidence: 99%

Small bowel bacterial overgrowth in subjects living in residential care homes

Lewis¹

1999

Age and Ageing

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“…Sometimes the conflict is acute, symptomatic; more often damages all body although progressing without any awareness (overall subclinical inflammation). Bacteria double every 10-20 minutes in the small intestinal nutrients [60][61][62][63][64][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96]. The mucosa of the small intestine hosts half the body production of immune cells and sustains a permanent moderate local inflammation, consisting of IgA and phagocytic responses, "tolerant" inflammation [97][98][99].…”

Section: Immune Involvementmentioning

confidence: 99%

“…About one hundred commensal bacteria are immunogenic in the human intestine [69]. An increase in this bacterial growth to about one billion per gram of mucosa provokes increase in production of lymphocyte and of IgG antibodies and reactions with mucosal damages [75][76][77][78][79][80][81][82][83][84][85][86][87][88][89]. The local inflammation discharges antigens and activated monocytes in circulation, producing a subclinical inflammation throughout the body .…”

Section: Immune Involvementmentioning

confidence: 99%

Positive Energy Imbalance and Microflora Overgrowth

Ciampolini¹

2017

JPNC

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Minimal bacteria growth on small intestinal mucosa is associated with prompt absorption of food, as happens during insulin sensitivity . Any meal by meal excess intake over expenditure (insulin resistance) fosters microflora growth and reversible immune deficiency (RID: subclinical inflammation, overall inflammatory state, or pro-inflammatory state) [1,2,[66][67][68][69][70][71]. Overweight is the cumulative result of meal by meal positive balance for a period of time. Weight increase and fattening produce an increase in insulin resistance and RID. A weight stable is poorly effective on subclinical inflammation, and weight decreases diminish the overall inflammation. In the small intestine, unabsorbed food becomes harmful to mucosa and all the body for the existence of bacteria in the intestinal lumen and the possibility of an active proliferation inside the lumen until food is available [68]. On the contrary, rearing experimental animals without bacteria reduced to 10% cellular infiltration and immunoglobulin production in small intestine mucosa [70]. Tropical enteropathy exhibits a denser infiltrate than normal mucosa in dependence on absorption slowdown in a warm and humid climate.The conception of intestinal saprophytes was rather naïve. Bacteria grow in the colon and everywhere in dependence of water and available nutrients and temperature. Water is freely available on mucosal surfaces, and nutrients (carbohydrates, proteins) depend on eating and more precisely on current energy balance. We compared the xylose absorption rate in two groups of experimental animals, one at the environmental temperature of 30 °C and the other at 6 °C environmental temperature [59]. At high environmental temperature, the absorption rate halved in comparison to animals kept at low temperature. We obtained similar results in humans [60]. A slowdown of metabolic and absorption rates explain unexpected microflora growth [59][60][61][62][63][64]. Bacteria in the colon double every day, very slowly in comparison with growth in the small intestine, where bacteria can double every 15 minutes [68]. Bacteria obtain little energy from nonabsorbable, indigestible fibers in absence of oxygen. All meat, bread and every good meal component do not arrive to the colon. These highly energetic foods would promote an explosive growth. The rumen is similar to the human colon in hosting bacteria in an ambient that has poor nutrients and is absolutely devoid of oxygen. Energy rich nutrients let develop one-two liters of carbodioxid per minute in the rumen. The small intestine is also anaerobic, and oxygen absence increases toward the end of the intestine. 60% of bacteria do not stimulate any immune response [69]. 10%-15% evoke a response by IgG lymphocytes and neutrophils that are destructive on invading bacteria, mucosa and overall in the body by subclinical inflammation. Minimal bacteria growth requires minimal persistence of nutrients in the small intestine lumen like on teeth. This depends on intake amount and rhythm. Amounts and intervals can be...

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“…Aunque el aspirado y el cultivo directo del contenido intestinal son considerados el estándar de oro para el diagnóstico del SBI 35 , estos méto-dos poseen limitaciones, como la potencial contaminación con flora bacteriana orofaríngea durante el procedimiento y el hecho de que las bacterias pueden estar en parche y por tanto no ser captadas con un único aspirado. Además el SBI puede comprometer sólo las áreas más distales del intestino delgado, quedando fuera del alcance de la instrumentalización habitual.…”

Section: A R T í C U L O D E R E V I S I ó Nunclassified

Sobrecrecimiento bacteriano intestinal: An update

Quera

Quigley

2005

Rev. méd. Chile

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Small intestinal bacterial overgrowth (SIBO) is characterized by nutrient malabsorption, associated with an excessive number of bacteria in the proximal ARTÍCULO DE REVISIÓNCorrespondencia a: Dr. Rodrigo Quera P. Sección de Gastroenterología, Hospital Clínico de la Universidad de Chile. Santos Dumont 999, Independencia, Santiago. Telé-fono: 6788350. E mail: rodrigoquera@yahoo.es L a microflora gastrointestinal humana es un complejo ecosistema de aproximadamente 500 especies bacterianas que colonizan el tracto alimentario poco después del nacimiento y que mantienen su composición relativamente constante a través de la vida 1 . Normalmente, sólo un pequeño número es encontrado en el intestino delgado al compararlos con los existentes en el colon. Dado que la flora bacteriana es excluida del intestino delgado, se evita su competencia con el hospedero en el sitio de digestión y absorción de alimentos. Cultivos de contenido yeyunal pueden no detectar bacterias hasta en 33% de los sujetos sanos. Cuando las bacterias están presentes, ellas son usualmente lactobacillus, enterococo, estreptococo, y otras bacterias aeróbicas gram (+) o anaerobios facultativos. El recuento bacteriano raramente supera las 10 4 unidades formadoras de colonias (UFC). La microbiología del íleon terminal representa una área de transición entre la escasez de bacterias en el yeyuno, principalmente especies aeróbicas, y la densa población de bacterias anaeróbicas encontradas en el colon. El

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The diagnosis of small bowel bacterial overgrowth

Cited by 306 publications

References 30 publications

Small bowel bacterial overgrowth in subjects living in residential care homes

Small bowel bacterial overgrowth in subjects living in residential care homes

Positive Energy Imbalance and Microflora Overgrowth

Sobrecrecimiento bacteriano intestinal: An update

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