Intestinal bacterial overgrowth after Roux-en-Y gastric bypass.
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.
Machado
Juliana Deh Carvalho
JD
Department of Internal Medicine, Hospital of the School of Medicine of Ribeirão Preto, Ribeirão Preto, Brazil. juliana@infonet.com.br
Campos
Camila Scalassara
CS
Lopes Dah Silva
Carolina
C
Marques Suen
Vivian Miguel
VM
Barbosa Nonino-Borges
Carla
C
Dos Santos
José Ernesto
JE
Ceneviva
Reginaldo
R
Marchini
Júlio Sérgio
JS
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