title: Duodenal Aspirates for Small Intestine Bacterial Overgrowth: Yield, PPIs, and Outcomes after Treatment at a Tertiary Academic Medical Center.
abstract: Duodenal aspirates are not commonly collected, but they can be easily used in detection of small intestinal bacterial overgrowth (SIBO). Proton pump inhibitor (PPI) use has been proposed to contribute to the development of SIBO. We aimed to determine the yield of SIBO-positive cultures detected in duodenal aspirates, the relationship between SIBO and PPI use, and the clinical outcomes of patients identified by this method. In a retrospective study, we analyzed electronic medical records from 1263 consecutive patients undergoing upper endoscopy at a tertiary medical center. Aspirates were collected thought out the third and fourth portions of the duodenum, and cultures were considered to be positive for SIBO if they produced more than 100,000 cfu/mL. Culture analysis of duodenal aspirates identified SIBO in one-third of patients. A significantly higher percentage of patients with SIBO use PPIs than patients without SIBO, indicating a possible association. Similar proportions of patients with SIBO improved whether or not they received antibiotic treatment, calling into question the use of this expensive therapy for this disorder.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Franco
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Molly B
authors.initials: MB
authors.lastname: Disbrow
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Allon
authors.initials: A
authors.lastname: Kahn
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Koepke
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Lucinda A
authors.initials: LA
authors.lastname: Harris
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: M Edwyn
authors.identifier: 0000-0003-4468-4806
authors.initials: ME
authors.lastname: Harrison
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Michael D
authors.identifier: 0000-0002-1162-3831
authors.initials: MD
authors.lastname: Crowell
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Francisco C
authors.initials: FC
authors.lastname: Ramirez