Christian Medical College, Vellore, India.
Scand J Gastroenterol. 2021 May;56(5):588-593. doi: 10.1080/00365521.2021.1900383. Epub 2021 Mar 17.
A subset of chronic pancreatitis patients respond poorly to pancreatic enzyme replacement therapy. Small intestinal bacterial overgrowth (SIBO) is considered to be one of the major reasons for this poor response. Previous studies have reported a wide range of prevalence of SIBO in patients with chronic pancreatitis. We aimed to assess the prevalence of SIBO in chronic pancreatitis using quantitative jejunal aspirate culture and glucose hydrogen breath test (GHBT). The sensitivity and specificity of GHBT for the diagnosis of SIBO in chronic pancreatitis were also estimated.
Newly diagnosed chronic pancreatitis patients were recruited into the study. A detailed history and relevant laboratory tests were done. All patients underwent an endoscopy and jejunal fluid aspiration for bacterial cultures and GHBT to detect SIBO. The results of GHBT were compared with jejunal fluid aspirate culture.
The jejunal aspirate culture was positive in 18/48 (37.5%) patients while the GHBT showed that 14/48 (29%) patients had SIBO. The sensitivity, specificity, positive and negative predictive value of GHBT in our study was 44.4, 80, 57.14 and 70.59%, respectively.
SIBO is not uncommon in chronic pancreatitis patients. One-third of our study population had SIBO. GHBT has low sensitivity but had high specificity in the diagnosis of SIBO in chronic pancreatitis.
一部分慢性胰腺炎患者对胰酶替代治疗反应不佳。小肠细菌过度生长（SIBO）被认为是这种治疗反应不佳的主要原因之一。先前的研究报告了慢性胰腺炎患者中 SIBO 的患病率差异很大。我们旨在使用定量空肠抽吸培养和葡萄糖氢呼气试验（GHBT）评估慢性胰腺炎患者中 SIBO 的患病率。还估计了 GHBT 对慢性胰腺炎中 SIBO 的诊断的灵敏度和特异性。
招募新诊断的慢性胰腺炎患者进行研究。进行详细的病史和相关的实验室检查。所有患者均进行内镜检查和空肠液抽吸进行细菌培养和 GHBT 以检测 SIBO。将 GHBT 的结果与空肠液抽吸培养进行比较。
18/48（37.5%）患者的空肠抽吸培养阳性，而 14/48（29%）患者的 GHBT 显示存在 SIBO。在我们的研究中，GHBT 的灵敏度、特异性、阳性预测值和阴性预测值分别为 44.4%、80%、57.14%和 70.59%。
SIBO 在慢性胰腺炎患者中并不罕见。我们研究人群中有三分之一患有 SIBO。GHBT 在诊断慢性胰腺炎中的 SIBO 时灵敏度较低，但特异性较高。
