title: Intestinal bacterial overgrowth after Roux-en-Y gastric bypass.
abstract: The aim of the present study was to report the occurrence of serious subnutrition, associated to intestinal bacterial overgrowth, in two patients submitted to bariatric surgery. Two female patients (body mass index, 49 and 50 kg/m(2), respectively) were submitted to Y-en-Roux gastric bypass. The first patient evolved a 52% loss of body weight within 21 months after surgery; the other, a 34% loss of initial body weight within 15 months after surgery, results corresponding, respectively, to 62 and 45 kg weight losses. However, both patients reported asthenia, hair fallout, and edema, and one also reported diarrhea, but none was feverish. Their respective albuminemias were of 24 and 23 g/l. A respiratory hydrogen test suggested bacterial hyperproliferation. Thirty days after ciprofloxacin and tetracyclin treatments, they showed improved albumin levels and nutritional states, both confirmed by results of hydrogen breath tests. Bacterial overgrowth is an important complication that can compromise clinical evolution of patients submitted to intestinal surgery like gastroplasty with Y-Roux anastomosis. In cases of clinical suspicion or a confirmed diagnosis, adequate antibiotics, sometimes requiring to be cyclically repeated, should be administered.
authors: Department of Internal Medicine, Hospital of the School of Medicine of Ribeirão Preto, Ribeirão Preto, Brazil. juliana@infonet.com.br
authors: Juliana Deh Carvalho
authors: JD
authors: Machado
authors: Camila Scalassara
authors: CS
authors: Campos
authors: Carolina
authors: C
authors: Lopes Dah Silva
authors: Vivian Miguel
authors: VM
authors: Marques Suen
authors: Carla
authors: C
authors: Barbosa Nonino-Borges
authors: José Ernesto
authors: JE
authors: Dos Santos
authors: Reginaldo
authors: R
authors: Ceneviva
authors: Júlio Sérgio
authors: JS
authors: Marchini
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000209:etiology* / Q000382:microbiology; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology* / Q000382:microbiology; D044342:Malnutrition / Q000209:etiology*; D015431:Weight Loss