title: The role of small intestinal bacterial overgrowth in postgastrectomy patients.
abstract: BACKGROUND
  Small intestinal bacterial overgrowth (SIBO) is expected in postgastrectomy patients; however, its role has not been clarified. This study was to estimate the prevalence of SIBO and investigate the clinical role of SIBO in postgastrectomy patients.
  
  
  METHODS
  This prospective study involved 76 patients who underwent gastrectomy for early gastric cancer with no evidence of recurrence. An H(2)-CH(4) breath test with oral glucose challenge test was performed to diagnose SIBO and dumping syndrome. Sigstad dumping questionnaires, serum glucose, hematocrit and pulse rate were simultaneously monitored for every 30 min for 3 hours.
  
  
  RESULTS
  There were significant differences in SIBO between the postgastrectomy patients and controls (77.6%vs 6.7%, P < 0.01). Abdominal fullness or borborygmus during oral glucose load were more common in SIBO-positive than in negative patients (50.8%vs 17.6%, P = 0.03), and were the independent factors for predicting SIBO in postgastrectomy patients (P = 0.02). The prevalences of dumping syndrome and hypoglycemia after oral glucose were 35 (46.1%) and 19 (25.0%), and were not different between both groups. However, the plasma glucose was significantly lower in SIBO-positive than in SIBO-negative patients at 120 and 150 min after oral glucose load (P < 0.05). No significant differences were observed in pulse rate and hematocrit in both groups.
  
  
  CONCLUSIONS
  SIBO is common among postgastrectomy patients. It appears to be associated with postprandial intestinal symptoms and might aggravate late hypoglycemia. SIBO could be a new therapeutic target for managing intestinal symptoms in postgastrectomy patients.
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: C N
authors.initials: CN
authors.lastname: Paik
authors.forename: M-G
authors.initials: MG
authors.lastname: Choi
authors.forename: C H
authors.initials: CH
authors.lastname: Lim
authors.forename: J M
authors.initials: JM
authors.lastname: Park
authors.forename: W C
authors.initials: WC
authors.lastname: Chung
authors.forename: K-M
authors.initials: KM
authors.lastname: Lee
authors.forename: K-H
authors.initials: KH
authors.lastname: Jun
authors.forename: K Y
authors.initials: KY
authors.lastname: Song
authors.forename: H M
authors.initials: HM
authors.lastname: Jeon
authors.forename: H-M
authors.initials: HM
authors.lastname: Chin
authors.forename: C H
authors.initials: CH
authors.lastname: Park
authors.forename: I-S
authors.initials: IS
authors.lastname: Chung
mesh_terms: D000368:Aged; D001419:Bacteria / Q000254:growth & development*; D001944:Breath Tests; D004377:Dumping Syndrome; D005260:Female; D005743:Gastrectomy; D005951:Glucose Tolerance Test; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery; D011795:Surveys and Questionnaires