Clinical and nutritional parameters in patients of chronic pancreatitis (CP) with small intestinal bacterial overgrowth (SIBO) and the effect of routine treatment of SIBO in these patients
Journal Title: International Journal of Medical and Health Research - Year 2019, Vol 5, Issue 1
Abstract
Background: Small intestinal bacterial overgrowth (SIBO) is significantly associated with chronic pancreatitis (CP). No study has evaluated the clinical and nutritional outcome of patients after successful treatment of SIBO in CP. Methods: 92 CP patients were prospectively analysed with Glucose and Lactulose Hydrogen Breath test (GHBT and LHBT) for presence of SIBO. Patients positive for SIBO on either of the breath test were given Rifaximin 400 mg thrice daily for 2 weeks and their GHBT and LHBT were repeated. Clinical and nutritional parameters at baseline and after the treatment were analyzed. Oro-cecal transit time was also calculated. Results: None of the 87 patients undergoing GHBT showed a persistent rise in breath H2 12 ppm above basal. 3 out of 76 patients undergoing LHBT showed a double peak of H2 in LHBT and were considered as having SIBO according to study protocol. No significant difference in the parameters analyzed was found among those having and not having SIBO. Sub group analysis of data to include patients having fasting breath H2≥ 20ppm in GHBT/ LHBT or those showing H2 rise of >20ppm from baseline in ≤90minutes in LHBT was also done. These 15 patients had significantly (p<0.05) lower BMI, shorter mid-arm circumference and shorter oro-cecal transit time. The mean and median oro-cecal transit time was 162.6 and 150 minutes respectively (range 75-240 minutes). No significant difference in oro-cecal transit time between those having and not having diabetes mellitus (DM) was seen. Treatment of 3 patients for SIBO resulted in normalization of HBT but did not result in any significant change in the parameters considered after 24 weeks. Conclusion: SIBO in CP patients is potentially associated with malnutrition. Treatment of SIBO results in normalization of HBT. The oro-cecal transit time is prolonged in CP and is not affected by DM.
Authors and Affiliations
Dr. Supriya Sharma, Dr. Hitesh Kalita, Dr. Hemanta K Nayak, Dr. Uday C Ghoshal, Dr. Samir Mohindra, Dr. Vivek A Saraswat, Dr. Gaurav Pande
Keywords
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