Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Clin Transl Gastroenterol. 2020 Dec 23;12(1):e00291. doi: 10.14309/ctg.0000000000000291.
Small intestinal bacterial overgrowth (SIBO) might be associated with a history of abdominal surgery. We aimed to evaluate the prevalence of SIBO and to investigate serum gastrin and pepsinogen as predictors of SIBO in patients with a history of hysterectomy, gastrectomy, or cholecystectomy.
This prospective study surveyed 146 patients with a history of hysterectomy, gastrectomy, or cholecystectomy, and 30 healthy controls, who underwent a hydrogen (H2)-methane (CH4) glucose breath test (GBT) for SIBO. Serum pepsinogen I and II and gastrin levels were reviewed.
GBT positivity (+) was significantly higher in patients with histories of abdominal surgery than that in in controls (37.6% vs 13.3%, P < 0.01). Among GBT+ patients, 36.0% (18/50), 96.2% (25/26), and 17.1% (12/70) were in the hysterectomy, gastrectomy, and cholecystectomy groups, respectively. Among the GBT subtypes, 43.6% (24/55), 10.9% (6/55), and 45.5% (25/55) of patients were in the GBT(H2)+, GBT(CH4)+, and GBT(mixed)+ groups, respectively. The gastrectomy group had significantly more GBT+ or GBT(H2)+ patients than the other surgical groups. Gastrin levels were higher in GBT(H2)+ patients and lower in GBT(CH4)+ patients than those in GBT- patients. Previous gastrectomy and elevated gastrin levels were independent predictive factors of GBT(H2)+.
SIBO is not uncommon in patients with histories of abdominal surgeries, but it is more common in patients who have undergone gastrectomy. Serum gastrin level could be a serologic predictor of H2-producing SIBO. The relationship between serum gastrin and SIBO requires further research.
小肠细菌过度生长（SIBO）可能与腹部手术史有关。我们旨在评估 SIBO 的患病率，并研究胃泌素和胃蛋白酶原作为既往行子宫切除术、胃切除术或胆囊切除术患者 SIBO 的预测因子。
本前瞻性研究调查了 146 例既往行子宫切除术、胃切除术或胆囊切除术的患者和 30 例健康对照者，他们接受了氢（H2）-甲烷（CH4）葡萄糖呼气试验（GBT）以检测 SIBO。回顾了血清胃蛋白酶原 I 和 II 以及胃泌素水平。
有腹部手术史的患者 GBT 阳性（+）显著高于对照组（37.6%比 13.3%，P < 0.01）。在 GBT+患者中，分别有 36.0%（18/50）、96.2%（25/26）和 17.1%（12/70）来自子宫切除术、胃切除术和胆囊切除术组。在 GBT 亚型中，分别有 43.6%（24/55）、10.9%（6/55）和 45.5%（25/55）的患者为 GBT（H2）+、GBT（CH4）+和 GBT（混合）+。胃切除术组 GBT+或 GBT（H2）+患者明显多于其他手术组。GBTH2+患者的胃泌素水平较高，而 GBT（CH4）+患者的胃泌素水平较低。既往胃切除术和高胃泌素水平是 GBT（H2）+的独立预测因素。
SIBO 在有腹部手术史的患者中并不少见，但在胃切除术患者中更为常见。血清胃泌素水平可能是产 H2 SIBO 的血清学预测因子。血清胃泌素与 SIBO 之间的关系需要进一步研究。
