Thomas Mouillot1,2, Nybel Rhyman3, Cyril Gauthier4, Justine Paris5, Anne-Sophie Lang5, Sarah Lepers-Tassy6, Sylvain Manfredi3, Côme Lepage3, Corinne Leloup6, Agnès Jacquin-Piques6,7, Marie-Claude Brindisi6,8, Laurent Brondel6,3. 1. Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000, Dijon, France. thomas.mouillot@chu-dijon.fr. 2. Service d'hépato-gastro-entérologie, CHU F. Mitterrand, F-21000, Dijon, France. thomas.mouillot@chu-dijon.fr. 3. Service d'hépato-gastro-entérologie, CHU F. Mitterrand, F-21000, Dijon, France. 4. Espace Médical Nutrition et Obésité, Ramsay Santé, 4 rue Lounes Matoub, F-21000, Dijon, France. 5. Service de Pharmacie, CHU F. Mitterrand, F-21000, Dijon, France. 6. Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000, Dijon, France. 7. Service de neurophysiologie clinique, CHU F. Mitterrand, F-21000, Dijon, France. 8. Service d'endocrinologie et diabétologie, CHU F. Mitterrand, F-21000, Dijon, France.
Abstract
INTRODUCTION: Small intestinal bacterial overgrowth (SIBO) is a common complication of bariatric surgery. Digestive decontamination treatments with oral antibiotic therapy vary and are not codified. This retrospective study was conducted to analyse the characteristics of bariatric surgery patients who underwent a glucose breath test (GBT) and to analyse the effectiveness of the antibiotic decontamination therapy. MATERIALS AND METHODS: A total of 101 operated patients (Roux-en-Y bypass (RYB), omega bypass (ΩB) and sleeve gastrectomy (SG)) who underwent a GBT (75 g/250 mL) were included. Anthropometric data, symptoms of SIBO, type of surgery, use of proton pump inhibitors (PPIs) and antibiotic therapy were analysed. The effectiveness of the antibiotic treatment, defined by improvement of the symptoms, was evaluated during the follow-up. RESULTS: Of the 85 women and 16 men included (48.5 ± 3.6 years old), 63 underwent RYB, 31 underwent ΩB and 7 underwent SG. The GBT was positive in 83% of the patients. A positive test was associated with age (p < 0.001), female sex (p < 0.01) and PPI use (p < 0.01), but there was no significant difference according to the type of surgery. Sixty-one percent of patients treated with gentamicin/metronidazole sequential antibiotic therapy and 58% of patients treated with metronidazole alone achieved treatment efficacy (with no significant difference in efficacy between these treatments). CONCLUSION: SIBO should be systematically considered in the context of abdominal symptoms in bariatric surgery patients, regardless the type of surgery, particularly in patients who are older or female and after PPI treatment. Digestive decontamination appears to be similar between gentamycin/metronidazole and metronidazole treatments.
INTRODUCTION:Small intestinal bacterial overgrowth (SIBO) is a common complication of bariatric surgery. Digestive decontamination treatments with oral antibiotic therapy vary and are not codified. This retrospective study was conducted to analyse the characteristics of bariatric surgery patients who underwent a glucose breath test (GBT) and to analyse the effectiveness of the antibiotic decontamination therapy. MATERIALS AND METHODS: A total of 101 operated patients (Roux-en-Y bypass (RYB), omega bypass (ΩB) and sleeve gastrectomy (SG)) who underwent a GBT (75 g/250 mL) were included. Anthropometric data, symptoms of SIBO, type of surgery, use of proton pump inhibitors (PPIs) and antibiotic therapy were analysed. The effectiveness of the antibiotic treatment, defined by improvement of the symptoms, was evaluated during the follow-up. RESULTS: Of the 85 women and 16 men included (48.5 ± 3.6 years old), 63 underwent RYB, 31 underwent ΩB and 7 underwent SG. The GBT was positive in 83% of the patients. A positive test was associated with age (p < 0.001), female sex (p < 0.01) and PPI use (p < 0.01), but there was no significant difference according to the type of surgery. Sixty-one percent of patients treated with gentamicin/metronidazole sequential antibiotic therapy and 58% of patients treated with metronidazole alone achieved treatment efficacy (with no significant difference in efficacy between these treatments). CONCLUSION: SIBO should be systematically considered in the context of abdominal symptoms in bariatric surgery patients, regardless the type of surgery, particularly in patients who are older or female and after PPI treatment. Digestive decontamination appears to be similar between gentamycin/metronidazole and metronidazole treatments.
Authors: Nathalia Ramori Farinha Wagner; Marilia Rizzon Zaparolli Ramos; Ligia de Oliveira Carlos; Magda Rosa Ramos da Cruz; Cesar Augusto Taconeli; Alcides José Branco Filho; Luis Sergio Nassif; Maria Eliana Madalozzo Schieferdecker; Antônio Carlos Ligocki Campos Journal: Obes Surg Date: 2020-08-11 Impact factor: 4.129
Authors: Uday C Ghoshal; Sanjeev Sachdeva; Ujjala Ghoshal; Asha Misra; Amarender Singh Puri; Nitesh Pratap; Ayesha Shah; M Masudur Rahman; Kok Ann Gwee; Victoria P Y Tan; Tahmeed Ahmed; Yeong Yeh Lee; B S Ramakrishna; Rupjyoti Talukdar; S V Rana; Saroj K Sinha; Minhu Chen; Nayoung Kim; Gerald Holtmann Journal: Indian J Gastroenterol Date: 2022-10-10