PMID- 23574267
OWN - NLM
STAT- MEDLINE
DCOM- 20131031
LR  - 20220330
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Print)
IS  - 0269-2813 (Linking)
VI  - 37
IP  - 11
DP  - 2013 Jun
TI  - Dysmotility and proton pump inhibitor use are independent risk factors for small 
      intestinal bacterial and/or fungal overgrowth.
PG  - 1103-11
LID - 10.1111/apt.12304 [doi]
AB  - BACKGROUND: Whether intestinal dysmotility and the use of a proton pump inhibitor 
      (PPI) either independently or together contributes to small intestinal bacterial 
      overgrowth (SIBO), and/or small intestinal fungal overgrowth (SIFO) is not known. 
      AIM: To investigate the role of dysmotility and PPI use in patients with 
      persistent gastrointestinal complaints. METHODS: Patients with unexplained 
      gastrointestinal symptoms and negative endoscopy/radiology tests completed a 
      validated symptom questionnaire and underwent 24-h ambulatory 
      antro-duodeno-jejunal manometry (ADJM). Simultaneously, duodenal aspirate was 
      obtained for aerobic, anaerobic and fungal culture. Dysmotility was diagnosed by 
      (>2): absent phase III MMC, absent/diminished postprandial response, diminished 
      amplitude of antral/intestinal phasic activity, impaired antro-duodenal 
      coordination. Bacterial growth >/=10(3) CFU/mL or fungal growth was considered 
      evidence for SIBO/SIFO. PPI use was documented. Correlation of symptoms with 
      presence of SIBO or SIFO was assessed. RESULTS: One hundred and fifty subjects 
      (M/F = 47/103) were evaluated; 94/150 (63%) had overgrowth: 38/94 (40%) had SIBO, 
      24/94 (26%) had SIFO and 32/94 (34%) had mixed SIBO/SIFO. SIBO was predominately 
      due to Streptococcus, Enterococcus, Klebsiella and E. coli. SIFO was due to 
      Candida. Eighty of 150 (53%) patients had dysmotility and 65/150 (43%) used PPI. 
      PPI use (P = 0.0063) and dysmotility (P = 0.0003) were independent significant 
      risk factors (P < 0.05) for overgrowth, but together did not pose additional 
      risk. Symptom profiles were similar between those with or without SIBO/SIFO. 
      CONCLUSIONS: Dysmotility and PPI use were independent risk factors for SIBO or 
      SIFO and were present in over 50% of subjects with unexplained gastrointestinal 
      symptoms. Diagnosis of overgrowth requires testing because symptoms were poor 
      predictors of overgrowth.
CI  - (c) 2013 Blackwell Publishing Ltd.
FAU - Jacobs, C
AU  - Jacobs C
AD  - Department of Internal Medicine, University of Iowa Carver College of Medicine, 
      Iowa City, IA, USA.
FAU - Coss Adame, E
AU  - Coss Adame E
FAU - Attaluri, A
AU  - Attaluri A
FAU - Valestin, J
AU  - Valestin J
FAU - Rao, S S C
AU  - Rao SS
LA  - eng
GR  - R01 DK057100/DK/NIDDK NIH HHS/United States
GR  - R01 HD057100/HD/NICHD NIH HHS/United States
GR  - 2R01 KD57100-05A2/PHS HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20130410
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Aliment Pharmacol Ther. 2014 Apr;39(8):902-3. PMID: 24635318
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bacteria/isolation & purification
MH  - Bacterial Infections/*microbiology
MH  - Colony-Forming Units Assay
MH  - Enteritis/*microbiology
MH  - Female
MH  - Fungi/isolation & purification
MH  - Gastrointestinal Diseases/*complications
MH  - *Gastrointestinal Motility
MH  - Humans
MH  - Intestine, Small/*microbiology
MH  - Male
MH  - Middle Aged
MH  - Mycoses/*microbiology
MH  - Proton Pump Inhibitors/*adverse effects
MH  - Risk Factors
MH  - Young Adult
PMC - PMC3764612
MID - NIHMS457544
EDAT- 2013/04/12 06:00
MHDA- 2013/11/01 06:00
PMCR- 2014/06/01
CRDT- 2013/04/12 06:00
PHST- 2012/11/05 00:00 [received]
PHST- 2012/11/28 00:00 [revised]
PHST- 2013/03/16 00:00 [revised]
PHST- 2013/03/16 00:00 [accepted]
PHST- 2013/04/12 06:00 [entrez]
PHST- 2013/04/12 06:00 [pubmed]
PHST- 2013/11/01 06:00 [medline]
PHST- 2014/06/01 00:00 [pmc-release]
AID - 10.1111/apt.12304 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2013 Jun;37(11):1103-11. doi: 10.1111/apt.12304. Epub 
      2013 Apr 10.