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Consequences of Small Intestinal Bacterial Overgrowth in Obese Patients Before and After Bariatric Surgery

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Abstract

Background and Aims

Small intestinal bacterial overgrowth (SIBO) has been described in obese patients. The aim of this study was to prospectively evaluate the prevalence and consequences of SIBO in obese patients before and after bariatric surgery.

Patients and Methods

From October 2001 to July 2009, in obese patients referred for bariatric surgery (BMI >40 kg/m2 or >35 in association with comorbidities), a glucose hydrogen (H2) breath test (BT) was performed before and/or after either Roux-en-Y gastric bypass (RYGBP) or adjustable gastric banding (AGB) to assess the presence of SIBO. Weight loss and serum vitamin concentrations were measured after bariatric surgery while a multivitamin supplement was systematically given.

Results

Three hundred seventy-eight (mean ± SD) patients who performed a BT before and/or after surgery were included: before surgery, BT was positive in 15.4 % (55/357). After surgery, BT was positive in 10 % (2/20) of AGB and 40 % (26/65) of RYGBP (p < 0.001 compared to preoperative situation). After RYGBP, patients with positive BT had similar vitamin levels, a lower caloric intake (983 ± 337 vs. 1271 ± 404 kcal/day, p = 0.014) but a significant lower weight loss (29.7 ± 5.6 vs. 37.7 ± 12.9 kg, p = 0.002) and lower percent of total weight loss (25.6 ± 6.0 vs. 29.2 ± 6.9 %, p = 0.044).

Conclusion

In this study, SIBO is present in 15 % of obese patients before bariatric surgery. This prevalence does not increase after AGB while it rises up to 40 % of patients after RYGBP and it is associated with lower weight loss.

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Acknowledgments

This study was performed with a funding of the French National Society of Gastroenterology (Fond Aide à la Recherche, 2008 de la SNFGE).

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Authors and Affiliations

  1. Service de Gastroentérologie, AP-HP, Hôpital Louis Mourier, HUPNVS, 178 rue des Renouillers, Colombes, France

    Jean-Marc Sabate, Benoit Coffin & Pauline Jouet

  2. Service d’Explorations Fonctionnelles, Centre Intégré Nord Francilien de prise en charge de l’Obésité (CINFO), AP-HP, Hôpital Louis Mourier, HUPNVS, Colombes, France

    Muriel Coupaye & Séverine Ledoux

  3. Service de Chirurgie digestive, Centre Intégré Nord Francilien de prise en charge de l’Obésité (CINFO), AP-HP, Hôpital Louis Mourier, HUPNVS, Colombes, France

    Benjamin Castel & Simon Msika

  4. Faculté de médecine, Denis Diderot Paris 7, 75010, Paris, France

    Jean-Marc Sabate, Séverine Ledoux, Simon Msika & Benoit Coffin

Authors
  1. Jean-Marc Sabate
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  2. Muriel Coupaye
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  3. Séverine Ledoux
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  4. Benjamin Castel
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  5. Simon Msika
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  6. Benoit Coffin
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  7. Pauline Jouet
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Correspondence to Jean-Marc Sabate.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Sabate, JM., Coupaye, M., Ledoux, S. et al. Consequences of Small Intestinal Bacterial Overgrowth in Obese Patients Before and After Bariatric Surgery. OBES SURG 27, 599–605 (2017). https://doi.org/10.1007/s11695-016-2343-5

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