title: Small intestinal bacterial overgrowth in inactive Crohn's disease: influence of thiopurine and biological treatment.
abstract: OBJECTIVE
  To investigate the influence of thiopurines and biological drugs on the presence of small intestinal bacterial overgrowth (SIBO) in patients with inactive Crohn's disease (CD).
  
  
  METHODS
  This was a prospective study in patients with CD in remission and without corticosteroid treatment, included consecutively from 2004 to 2010. SIBO was investigated using the hydrogen glucose breath test.
  
  
  RESULTS
  One hundred and seven patients with CD in remission were included. Almost 58% of patients used maintenance immunosuppressant therapy and 19.6% used biological therapy. The prevalence of SIBO was 16.8%. No association was observed between SIBO and the use of thiopurine Immunosuppressant (12/62 patients), administration of biological drugs (2/21 patients), or with double treatment with an anti-tumor necrosis factor drugs plus thiopurine (1/13 patients). Half of the patients had symptoms that were suggestive of SIBO, though meteorism was the only symptom that was significantly associated with the presence of SIBO on univariate analysis (P < 0.05). Multivariate analysis revealed that the presence of meteorism and a fistulizing pattern were associated with the presence of SIBO (P < 0.05).
  
  
  CONCLUSIONS
  Immunosuppressants and/or biological drugs do not induce SIBO in inactive CD. Fistulizing disease pattern and meteorism are associated with SIBO.
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sánchez-Montes
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Ortiz
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Bastida
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Ester
authors.initials: E
authors.lastname: Rodríguez
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Yago
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Beltrán
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Mariam
authors.initials: M
authors.lastname: Aguas
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Iborra
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Garrigues
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Ponce
authors.affiliation: Cristina Sánchez-Montes, Vicente Ortiz, Guillermo Bastida, Ester Rodríguez, María Yago, Belén Beltrán, Mariam Aguas, Marisa Iborra, Vicente Garrigues, Julio Ponce, Pilar Nos, Gastroenterology Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Nos
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects* / Q000254:growth & development; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D001944:Breath Tests; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D004359:Drug Therapy, Combination; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007421:Intestine, Small / Q000187:drug effects* / Q000276:immunology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011687:Purines / Q000009:adverse effects / Q000627:therapeutic use*; D012074:Remission Induction; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D001688:Biological Products; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D011687:Purines; D014409:Tumor Necrosis Factor-alpha
keywords: Bacterial overgrowth; Biologics; Crohn’s disease; Inflammatory bowel disease; Thiopurines