title: Consequences of Small Intestinal Bacterial Overgrowth in Obese Patients Before and After Bariatric Surgery.
abstract: Small intestinal bacterial overgrowth (SIBO) has been described in obese patients. The aim of this study was to prospectively evaluate the prevalence and consequences of SIBO in obese patients before and after bariatric surgery.
  
  
  
  From October 2001 to July 2009, in obese patients referred for bariatric surgery (BMI >40 kg/m2or >35 in association with comorbidities), a glucose hydrogen (H2) breath test (BT) was performed before and/or after either Roux-en-Y gastric bypass (RYGBP) or adjustable gastric banding (AGB) to assess the presence of SIBO. Weight loss and serum vitamin concentrations were measured after bariatric surgery while a multivitamin supplement was systematically given.
  
  
  
  Three hundred seventy-eight (mean ± SD) patients who performed a BT before and/or after surgery were included: before surgery, BT was positive in 15.4 % (55/357). After surgery, BT was positive in 10 % (2/20) of AGB and 40 % (26/65) of RYGBP (p < 0.001 compared to preoperative situation). After RYGBP, patients with positive BT had similar vitamin levels, a lower caloric intake (983 ± 337 vs. 1271 ± 404 kcal/day, p = 0.014) but a significant lower weight loss (29.7 ± 5.6 vs. 37.7 ± 12.9 kg, p = 0.002) and lower percent of total weight loss (25.6 ± 6.0 vs. 29.2 ± 6.9 %, p = 0.044).
  
  
  
  In this study, SIBO is present in 15 % of obese patients before bariatric surgery. This prevalence does not increase after AGB while it rises up to 40 % of patients after RYGBP and it is associated with lower weight loss.
authors: Service de Gastroentérologie, AP-HP, Hôpital Louis Mourier, HUPNVS, 178 rue des Renouillers, Colombes, France. jean-marc.sabate@aphp.fr.|Faculté de médecine, Denis Diderot Paris 7, 75010, Paris, France. jean-marc.sabate@aphp.fr.
authors: Jean-Marc
authors: JM
authors: Sabate
authors: Service d'Explorations Fonctionnelles, Centre Intégré Nord Francilien de prise en charge de l'Obésité (CINFO), AP-HP, Hôpital Louis Mourier, HUPNVS, Colombes, France.
authors: Muriel
authors: M
authors: Coupaye
authors: Service d'Explorations Fonctionnelles, Centre Intégré Nord Francilien de prise en charge de l'Obésité (CINFO), AP-HP, Hôpital Louis Mourier, HUPNVS, Colombes, France.|Faculté de médecine, Denis Diderot Paris 7, 75010, Paris, France.
authors: Séverine
authors: S
authors: Ledoux
authors: Service de Chirurgie digestive, Centre Intégré Nord Francilien de prise en charge de l'Obésité (CINFO), AP-HP, Hôpital Louis Mourier, HUPNVS, Colombes, France.
authors: Benjamin
authors: B
authors: Castel
authors: Service de Chirurgie digestive, Centre Intégré Nord Francilien de prise en charge de l'Obésité (CINFO), AP-HP, Hôpital Louis Mourier, HUPNVS, Colombes, France.|Faculté de médecine, Denis Diderot Paris 7, 75010, Paris, France.
authors: Simon
authors: S
authors: Msika
authors: Service de Gastroentérologie, AP-HP, Hôpital Louis Mourier, HUPNVS, 178 rue des Renouillers, Colombes, France.|Faculté de médecine, Denis Diderot Paris 7, 75010, Paris, France.
authors: Benoit
authors: B
authors: Coffin
authors: Service de Gastroentérologie, AP-HP, Hôpital Louis Mourier, HUPNVS, 178 rue des Renouillers, Colombes, France.
authors: Pauline
authors: P
authors: Jouet
mesh_terms: D000328:Adult; D001419:Bacteria / Q000254:growth & development; D050110:Bariatric Surgery / Q000009:adverse effects / Q000534:rehabilitation; D001765:Blind Loop Syndrome / Q000150:complications* / Q000382:microbiology / Q000601:surgery*; D002149:Energy Intake; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000534:rehabilitation; D000069196:Gastrointestinal Microbiome / Q000502:physiology*; D015391:Gastroplasty / Q000009:adverse effects / Q000534:rehabilitation; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
keywords: Microbiota; Roux-en-Y gastric bypass; Small intestinal bacterial overgrowth; Vitamins; Weight loss