Vallès Margarita, Antuori Alexandra, Mearin Fermín, Serra Jordi
Institut Guttmann (adscrito a la Universitat Autònoma de Barcelona), Badalona, Barcelona, España.
Institut Guttmann (adscrito a la Universitat Autònoma de Barcelona), Badalona, Barcelona, España.
Gastroenterol Hepatol. 2021 Oct;44(8):539-545. doi: 10.1016/j.gastrohep.2021.01.010. Epub 2021 Feb 26.
Spinal cord injury (SCI) patients may have intestinal dysmotility and digestive symptoms that are associated with small intestinal bacterial overgrowth (SIBO). The aim of this study is to describe the prevalence of SIBO in SCI patients and the risk factors of its development.
Twenty-nine consecutive SCI patients were studied (10 women/19 men; mean age 47 years), 16 with subacute injuries (<9 months) and 13 with chronic injuries (>1 year). Nine patients were affected by tetraplegia and 15 by paraplegia. Each patient underwent a glucose breath test according to the North American Consensus and the presence of abdominal symptoms was evaluated during the test. The results were compared with 15 non-neurological patients with SIBO.
Six patients tested positive for SIBO (21%), all of them affected by SCI in the subacute phase, 6/16 vs. 0/13 in the chronic phase (P<.05) and the majority with tetraplegia, 5/9 vs. 1/19 with paraplegia (P<.05). No statistically significant relationship was found with other clinical characteristics. All the tests were positive for methane or mixed (methane and hydrogen), while only 67% of the controls had methane-predominant production (P>.05).
SCI patients can develop SIBO, more frequently in the subacute phase and in tetraplegic patients, highlighting a high production of methane. This complication should be considered in neurogenic bowel management.
脊髓损伤（SCI）患者可能存在肠道运动障碍和消化症状，这些症状与小肠细菌过度生长（SIBO）有关。本研究的目的是描述SCI患者中SIBO的患病率及其发生的危险因素。
对29例连续的SCI患者进行研究（10名女性/19名男性；平均年龄47岁），其中16例为亚急性损伤（<9个月），13例为慢性损伤（>1年）。9例患者为四肢瘫痪，15例为截瘫。每位患者均根据北美共识进行葡萄糖呼气试验，并在试验期间评估腹部症状。将结果与15例患有SIBO的非神经科患者进行比较。
6例患者SIBO检测呈阳性（21%），所有这些患者均处于亚急性期SCI，慢性期为6/16 vs. 0/13（P<0.05），大多数为四肢瘫痪，5/9 vs. 截瘫患者为1/19（P<0.05）。未发现与其他临床特征有统计学意义的关系。所有检测结果对甲烷或混合气体（甲烷和氢气）均呈阳性，而只有67%的对照组以甲烷生成为主（P>0.05）。
SCI患者可发生SIBO，在亚急性期和四肢瘫痪患者中更常见，突出显示甲烷生成量高。在神经源性肠道管理中应考虑这种并发症。
