Testing and Treating Small Intestinal Bacterial Overgrowth Reduces Symptoms in Patients with Inflammatory Bowel Disease

Digestive Diseases and Sciences
Shirley Cohen-MekelburgBrian P Bosworth

Abstract

Common mechanisms against small intestinal bacterial overgrowth (SIBO), including an intact ileocecal valve, gastric acid secretion, intestinal motility, and an intact immune system, are compromised in inflammatory bowel disease (IBD), and therefore, a relatively high incidence of SIBO has been reported in this population. We aimed to determine whether an improvement in IBD clinical activity scores is seen after testing and treating SIBO. A retrospective cohort study of 147 patients with inflammatory bowel disease who were referred for SIBO breath testing from 1/2012 to 5/2016 was performed. Characteristics of SIBO positive and treated patients were compared to SIBO negative patients, including the changes in Partial Mayo Score or Harvey Bradshaw Index (HBI), using Student's t test for continuous variables and Chi-squared or Fisher's exact test for categorical variables. 61.9% were SIBO positive and treated, and 38.1% were SIBO negative. In Crohn's disease, the median HBI decreased from 5 to 3 and 5 to 4, in the SIBO positive and negative groups, respectively (p = 0.005). In ulcerative colitis, the Partial Mayo Score decreased from 2 to 1.5 and 2 to 1, respectively (p = 0.607). This study examines the clinical effect of testing...Continue Reading

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Citations

Jan 16, 2019·Current Gastroenterology Reports·Eamonn M M Quigley
May 21, 2020·International Journal of Molecular Sciences·Giuseppe LosurdoAlfredo Di Leo
Jul 27, 2021·Gastroenterology Clinics of North America·Edith Pérez de ArceEamonn M M Quigley
Jan 16, 2022·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Ayesha Shah, Gerald Holtmann

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