Kumar Kundan, Ghoshal Uday C, Srivastava Deepakshi, Misra Asha, Mohindra Samir
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raibareily Road, Lucknow, UP 226014, India.
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raibareily Road, Lucknow, UP 226014, India.
Pancreatology. 2014 Jul-Aug;14(4):280-3. doi: 10.1016/j.pan.2014.05.792. Epub 2014 May 27.
Small intestinal bacterial overgrowth (SIBO) is known to occur in patients with chronic pancreatitis, particularly of alcoholic etiology. There are, however, scanty data on frequency of SIBO in patients with chronic idiopathic pancreatitis and factors associated with its occurrence.
68 patients with chronic pancreatitis and 74 age and gender-matched healthy subjects (HS) were evaluated for SIBO using glucose hydrogen breath test (GHBT). Persistent rise in breath hydrogen 12 ppm above basal (at least two recordings) was diagnostic of SIBO.
SIBO was diagnosed more often among patients with chronic pancreatitis than controls (10/68 [14.7%] vs. 1/74 controls [1.3%]; p = 0.003). Of 68 patients, 22 (32.3%) had alcoholic and 46 (67.6%) had idiopathic chronic pancreatitis. SIBO was as commonly detected among patients with alcoholic as idiopathic pancreatitis (3/22 [13.6%] vs. 7/46 [15.2%]; p = 0.86). Age, gender, body mass index (BMI), steatorrhoea, pain, analgesic use, pancreatic calcifications and use of pancreatic enzyme supplements had no relationship with the presence of SIBO. Diabetes mellitus tended to be commoner among patients with chronic pancreatitis with than without SIBO (6/10 [60%] vs. 18/58 [31%]; p = 0.07).
SIBO was commoner among patients with chronic pancreatitis, both alcoholic and idiopathic, than HS. Though presence of SIBO among patients with chronic pancreatitis tended to be commoner among those with diabetes mellitus, there was no relationship with age, gender, BMI, steatorrhoea, pain, analgesic use, pancreatic calcifications and use of pancreatic enzyme supplements.
已知慢性胰腺炎患者，尤其是酒精性病因导致的慢性胰腺炎患者，会发生小肠细菌过度生长（SIBO）。然而，关于慢性特发性胰腺炎患者中SIBO的发生率及其发生相关因素的数据却很少。
采用葡萄糖氢呼气试验（GHBT）对68例慢性胰腺炎患者和74例年龄及性别匹配的健康受试者（HS）进行SIBO评估。呼气氢浓度持续升高超过基础值12 ppm（至少两次记录）可诊断为SIBO。
慢性胰腺炎患者中SIBO的诊断率高于对照组（10/68 [14.7%] 对比1/74对照组 [1.3%]；p = 0.003）。68例患者中，22例（32.3%）为酒精性慢性胰腺炎，46例（67.6%）为特发性慢性胰腺炎。酒精性胰腺炎患者和特发性胰腺炎患者中SIBO的检出率相同（3/22 [13.6%] 对比7/46 [15.2%]；p = 0.86）。年龄、性别、体重指数（BMI）、脂肪泻、疼痛、镇痛药物使用、胰腺钙化以及胰腺酶补充剂的使用与SIBO的存在均无关联。慢性胰腺炎合并SIBO的患者中糖尿病的发生率往往高于不合并SIBO的患者（6/10 [60%] 对比18/58 [31%]；p = 0.07）。
慢性胰腺炎患者，包括酒精性和特发性患者，SIBO的发生率高于健康受试者。虽然慢性胰腺炎合并SIBO的患者中糖尿病的发生率往往较高，但与年龄、性别、BMI、脂肪泻、疼痛、镇痛药物使用、胰腺钙化以及胰腺酶补充剂的使用均无关联。
