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Obesity Surgery

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01-02-2021 | Nausea | Original Contributions

Small Intestinal Bacterial Overgrowth: Clinical Presentation in Patients with Roux-en-Y Gastric Bypass

Authors: Russell D. Dolan, Jason Baker, Kimberly Harer, Allen Lee, William Hasler, Richard Saad, Allison R. Schulman

Published in: Obesity Surgery | Issue 2/2021

Abstract

Background

Small intestinal bacterial overgrowth (SIBO) is defined by an increased number of bacteria measured via exhaled hydrogen and/or methane gas following the ingestion of glucose. This condition is prevalent following abdominal surgery, including Roux-en-Y gastric bypass (RYGB), and associated with a variety of non-specific abdominal symptoms, often requiring an extensive diagnostic work-up.

Aim

To assess the frequency that individuals with RYGB anatomy are diagnosed with SIBO and if they are more likely to report specific gastrointestinal (GI) symptoms compared to individuals with native anatomy.

Methods

This large matched cohort study evaluated patients with GI symptoms who underwent a glucose breath test (GBT) for SIBO evaluation, utilizing 1:2 matching between RYGB and native anatomy. Patients with positive GBT were included in univariate and multivariate analyses to distinguish the presence of ten specific GI symptoms between RYGB and native anatomy.

Results

A total of 17,973 patients were included, where 271 patients with RYGB were matched to 573 patients with native anatomy that underwent GBT. Patients with RYGB anatomy and a positive GBT (199; 73.4%) as compared to those with native anatomy and a positive GBT (209; 36%) more often reported nausea, vomiting, bloating, and diarrhea. There were no differences between the two groups in the report of heartburn, regurgitation, chest pain, gas, or constipation.

Conclusions

SIBO is common in patients with RYGB and more commonly report nausea, vomiting, bloating, and diarrhea. The results of this study suggest that the report of these symptoms in RYGB should prompt early evaluation for SIBO.

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Title: Small Intestinal Bacterial Overgrowth: Clinical Presentation in Patients with Roux-en-Y Gastric Bypass
Authors: Russell D. Dolan
Jason Baker
Kimberly Harer
Allen Lee
William Hasler
Richard Saad
Allison R. Schulman
Publication date: 01-02-2021
Publisher: Springer US
Keywords: Nausea
Constipation
Vomiting
Diarrhea
Constipation
Diarrhea
Published in: Obesity Surgery / Issue 2/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-020-05032-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Small Intestinal Bacterial Overgrowth: Clinical Presentation in Patients with Roux-en-Y Gastric Bypass

Abstract

Background

Aim

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Methods

Results

Conclusions

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