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2022 Nov 15

Zhonghua Yi Xue Za Zhi



[Influence of infection and its eradication treatment on small intestinal bacterial overgrowth].


Zhu D, Wang XL, Dai Y, Li SY, Wang WH
Zhonghua Yi Xue Za Zhi. 2022 Nov 15; 102(42):3382-3387.
PMID: 36372768.


To analyze the effects of ( infection and eradication therapy on small intestinal bacterial overgrowth (SIBO). From September to December 2021, patients with abdominal symptoms who received C urea breath test at the Department of Gastroenterology in Peking University First Hospital were enrolled.C urea breath test was used to detect infection and patients were divided into positive and negative groups accordingly. Lactulose hydrogen methane breath test was performed to determine SIBO. positive patients were treated with quadruple therapy including amoxicillin, metronidazole, rabeprazole and bismuth potassium citrate. C urea breath test and lactulose hydrogen methane breath test were reexamined 6 weeks after the treatment. A total of 102 patients (49 males and 53 females) were enrolled, with a mean age of (42.1±9.9) years. Among them, 49 patients were negative and 53 were positive. Moreover, 47 patients were SIBO positive and 55 were SIBO negative. There was no significant difference in age, sex, body mass index, abdominal symptoms and the diagnosis of chronic atrophic gastritis between positive and negative patients at the enrollment (all >0.05). The detection rate of SIBO in infected patients was higher than that in uninfected patients, and the difference was statistically significant (60.4% vs 30.6%, =0.003). Patients with SIBO had significantly more frequent abdominal distension (36.2% vs 10.9%, =0.002) and constipation (27.7% vs 1.8%, <0.001) than patients without SIBO. The rate of SIBO after eradication treatment was significantly lower than that before treatment (20.8% vs 60.4%, <0.001). The remission rate of SIBO after eradication therapy was 66.7% (20/30). Besides, patients had obvious improvement of constipation (6.0% vs 18.9%, =0.008), and the incidence of other abdominal symptoms decreased to various degrees including diarrhea, abdominal pain, abdominal distention and poor appetite. infection increases the risk of SIBO, and the quadruple regimen containing amoxicillin and metronidazole has a therapeutic effect for patients with infection and concomitant SIBO.