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Delayed Gastric Emptying Is Not Associated with a Microbiological Diagnosis of Small Intestinal Bacterial Overgrowth

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Abstract

Background

Clinical symptoms of patients with small intestinal bacterial overgrowth (SIBO) may overlap with symptoms of gastroparesis. Prior studies suggest delayed small intestinal transit is associated with SIBO, but have not shown an association between delayed gastric emptying and SIBO. However, these studies have generally relied on the indirect method of breath testing to diagnose SIBO.

Aims

The aim of this study was to examine the association between a microbiological diagnosis of SIBO and delayed gastric emptying by scintigraphy.

Methods

In a single-center retrospective study of previous research participants who presented for small bowel enteroscopy for diagnostic evaluation of SIBO, we identified 73 participants who underwent gastric emptying study by scintigraphy. A microbiological diagnosis of SIBO was made in patients based on culture results of jejunal aspirates. Clinical symptoms were assessed using the total gastroparesis cardinal symptom index (GCSI) score. We compared delayed gastric emptying, 2- and 4-h gastric retention, and gastroparesis symptoms between patients with and without a microbiological diagnosis of SIBO.

Key Results

Among 29 participants with SIBO and 44 without SIBO, 33 (45%) had evidence of delayed gastric emptying. There was no significant association between a microbiological diagnosis of SIBO and delayed gastric emptying by scintigraphy. Percent retained at 2 and 4 h, and total GCSI scores did not differ significantly between those with and without SIBO.

Conclusions

Although delayed gastric emptying is common in patients with suspected SIBO, gastric emptying is not associated with a microbiological diagnosis of SIBO.

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Funding

AS is supported by NIDDK K23DK122015.

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 545 Barnhill Dr., Emerson Hall 305, Indianapolis, IN, 46202, USA

    Gerardo Calderon

  2. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 550 N. University Blvd Ste 1634H, Indianapolis, IN, 46202, USA

    Robert M. Siwiec

  3. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 550 University Blvd Ste 1634D, Indianapolis, IN, 46202, USA

    Matthew E. Bohm

  4. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 550 University Blvd Ste 1634, Indianapolis, IN, 46202, USA

    Thomas V. Nowak, John M. Wo & Anita Gupta

  5. Division of Gastroenterology and Hepatology, Department of Medicine, Department of Biostatistics, Indiana University School of Medicine, 410 W. 10th St, HS 3065, Indianapolis, IN, USA

    Huiping Xu

  6. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Ste 225, Indianapolis, IN, 46202, USA

    Andrea Shin

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  1. Gerardo Calderon
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Correspondence to Andrea Shin.

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Calderon, G., Siwiec, R.M., Bohm, M.E. et al. Delayed Gastric Emptying Is Not Associated with a Microbiological Diagnosis of Small Intestinal Bacterial Overgrowth. Dig Dis Sci 66, 160–166 (2021). https://doi.org/10.1007/s10620-020-06153-1

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  • DOI: https://doi.org/10.1007/s10620-020-06153-1

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