Eradication of small intestinal bacterial overgrowth and oro-cecal transit in diabetics.
OBJECTIVE
Gastrointestinal motility disorders are often present in diabetic patients. Even if this problem has been attributed to autonomic neuropathy, the pathophysiological mechanisms responsible are not completely defined. Aim of our study was to evaluate the effect of eradication of small-intestine bacterial overgrowth on oro-cecal transit time in diabetic patients in order to identify a possible role of bacterial overgrowth on dysmotility.


METHODS
We selected among 74 diabetic patients who underwent H2-lactulose breath test, 21 subjects (13M, 8F, mean age 43.7 years, 11 with type 1 and 10 with type 2 diabetes) affected by bacterial overgrowth and delayed oro-cecal transit time and with normal cardiovascular autonomic test. Patients were treated with rifaximin and underwent a control breath test. Data were analyzed using paired-data t-test.


RESULTS
Three patients still showed bacterial overgrowth, 5 persistent delayed transit time without bacterial overgrowth; 13 patients (62%) showed a significant (P < 0.001) reduction of on oro-cecal transit time without bacterial overgrowth.


CONCLUSIONS
Our results show that bacterial overgrowth may contribute to the delay of intestinal transit as confirmed by its significant improvement after eradication therapy.
Cuoco
Lucio
L
Institute of Internal Medicine, Division of Gastroenterology, Catholic University of the Sacred Heart, Rome, Italy. luciocuoco@tiscalinet.it
Montalto
Massimo
M
Jorizzo
Regina Anna
RA
Santarelli
Luca
L
Arancio
Fabiola
F
Cammarota
Giovanni
G
Gasbarrini
Giovanni
G
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D001944:Breath Tests; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology*; D007792:Lactulose / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D012294:Rifamycins; D007792:Lactulose; D000078262:Rifaximin