title: Small intestinal bacterial overgrowth in patients with chronic pancreatitis.
abstract: OBJECTIVE
  To assess the prevalence of small intestinal bacterial overgrowth (SIBO) in chronic pancreatitis (CP), and analyze factors related with SIBO in CP.
  
  
  BACKGROUND
  SIBO is to be considered a factor that worsens symptoms and nutritional status in patients with CP. However, the few studies evaluating the rate of SIBO in CP patients used nonuniform and nonstandardized procedures, and reported a wide range of positivity (0% to 92%). Those studies often investigated CP patients with previous resection surgery (cause of SIBO per se).
  
  
  METHODS
  CP patients and controls evaluated for SIBO by the H2 glucose breath test with a standard protocol. For CP patients, the relationship between test results, abdominal symptoms, and clinical and biochemical variables was analyzed.
  
  
  RESULTS
  A total of 43 CP patients and 43 controls were enrolled. Of the CP patients, 8 had advanced disease (defined by M-ANNHEIM index) and none had undergone previous surgery. The glucose breath test positivity rate was higher in the CP patients than in the controls (21% vs. 14%), albeit without a significant difference (P=0.57). Mean fasting H2 excretion and mean H2 excretion at 120 minutes also had a trend toward higher levels in CP patients. There were no clinical differences between CP patients with or without SIBO, but there were nutritional differences for lower levels of vitamin D and higher levels of folate in these patients with SIBO.
  
  
  CONCLUSIONS
  Our findings suggest that SIBO is not uncommon in uncomplicated CP patients. The lack of a significant difference compared with controls might be due to the study being underpowered. SIBO in CP patients does not seem to be related to peculiar clinical features, but it might affect nutritional status.
authors.affiliation: Digestive and Liver Disease Unit, S. Andrea Hospital, University "Sapienza," Rome, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Signoretti
authors.forename: Serena
authors.initials: S
authors.lastname: Stigliano
authors.forename: Roberto
authors.initials: R
authors.lastname: Valente
authors.forename: Matteo
authors.initials: M
authors.lastname: Piciucchi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Delle Fave
authors.forename: Gabriele
authors.initials: G
authors.lastname: Capurso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001765:Blind Loop Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D001944:Breath Tests; D016022:Case-Control Studies; D005260:Female; D005492:Folic Acid / Q000097:blood; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D015995:Prevalence; D012384:Rome / Q000453:epidemiology; D012720:Severity of Illness Index; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014807:Vitamin D; D005492:Folic Acid