Small intestine bacterial overgrowth-associated dyspepsia: myth or reality?


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Abstract

Background. A number of studies have shown that after the eradication of Helicobacter pylori infection, microbial colonization of the stomach and small intestine by anaerobic bacteria occurs in some patients, and the development of small intestine bacterial overgrowth (SIBO) is noted. Objective. To evaluate the possibility of developing SIBO-associated dyspepsia. Methods. Before and 5 weeks after successful anti-Helicobacter therapy, 40 patients with H. pylori-associated dyspepsia underwent evaluation of the frequency and severity of dyspepsia symptoms, quality of life (SF-36), hydrogen lactulose breath test (Gastro+Gastrolyzer, Bedfont Scientific Ltd , Kent, UK), and evaluation of the severity of concomitant irritable bowel syndrome (IBS; IBS-SS). Results. Five weeks after the successful eradication of H. pylori infection and the evaluation of dyspepsia symptoms, the patients were divided into 2 groups. Group 1 included 27 (67.5%) patients with a statistically significant decrease in dyspeptic complaints (p<0.05), group 2 - 13 (32.5%) patients with persistent dyspepsia symptoms (p>0.1). The decrease in dyspepsia symptoms in patients of group 1 was accompanied by a significant improvement in the quality of life (p<0.05). SIBO eradication was observed in 22 (91.6%) of 24 patients in group 1, and was not observed in patients of group 2 (p<0.05, Fisher’s exact test). The deterioration of the symptoms of concomitant IBS with constipation was not detected in patients of both groups. Conclusion. Eradication of H. pylori infection has a positive effect on clinical symptoms in 67.5% of patients with dyspepsia, and is accompanied by an increase in the quality of life. SIBO is one of the possible reasons for the persistence of dyspepsia symptoms in 32.5% of patients and can be considered as a new potential goal of treatment.

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About the authors

Sergey A. Alekseenko

Far-Eastern State Medical University

Email: sa.alexeenko@gmail.com
MD, Professor, Head Department of Hospital Therapy

O. V Krapivnaya

Khabarovsk-1 Road Clinical Hospital, OAO Russian Railways

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