Intestines bacterial overgrowth

Summary of Failure of the Gastric Acid Barrier Intestinal Bacterial Overgrowth When the gastric acid barrier fails the bacterial counts in the most proximal part of small bowel increase. Stan-... 

King CE, Toskes PP Small intestine bacterial overgrowth. Gastroenterology 1979 76 1035— 1055. 

Riordan SM, Mclver CJ, Walker BM, Dun-combe VM, Bolin TD, Thomas MC The lactulose breath hydrogen test and small intestinal bacterial overgrowth. Am J Gastroenterol 1996 91 1795-1803. 

Nelis GF, Engelage AH, Samson G Does longterm inhibition of gastric acid secretion with omeprazole lead to small intestinal bacterial overgrowth Neth J Med 1994 45 93-100. 

Shindo K, Machida M, Miyakawa K, Fukumura M A syndrome of cirrhosis, achlorhydria, small intestinal bacterial overgrowth, and fat malabsorption. Am J Gastroenterol 1993 88 2084-2091. 

Stotzer PO, Bjornsson ES, Abrahamsson H Interdigestive and postprandial motility in small intestinal bacterial overgrowth. Scand J Gastroenterol 1996,31 875-880. 

Riordan SM, Mclver CJ, Wakefield D, Bolin TD, Duncombe VM, Thomas MC Small intestinal bacterial overgrowth in the symptomatic elderly. Am J Gastroenterol 1997 92 47-51. 

Di Stefano M, Corazza GR Treatment of small intestine bacterial overgrowth and related symptoms by rifaximin. Chemotherapy 2005 51(suppl 1) 103-109. 

Lin HC Small intestinal bacterial overgrowth A framework for understanding irritable bowel syndrome. JAMA 2004 292 852-858. 

Strid H, Simren M, Stotzer PO, Ringstrom G, Abrahamsson H, Bjornsson ES Patients with chronic renal failure have abnormal small intestinal motility and a high prevalence of small intestinal bacterial overgrowth. Digestion 2003 67 129-137. 

Rifaximin Rifamycin Antibiotic Gut bacteria Enteric infection Diarrhea, infectious Hepatic encephalopathy Small intestine bacterial overgrowth Inflammatory bowel disease Colonic diverticular disease Irritable bowel syndrome Constipation Clostridium difficile infection Helicobacter pylori infection Colorectal surgery Bowel decontamination, selective Pancreatitis, acute Bacterial peritonitis, spontaneous Nonsteroidal anti-inflammatory drug enteropathy... 

Bacterial translocation is defined as the passage of viable indigenous bacteria from the GI tract to extraintesti-nal sites, such as the mesenteric lymph node complex, liver, spleen and bloodstream [183], Three major mechanisms promote bacterial translocation intestinal bacterial overgrowth, deficiencies in host immune defenses and increased permeability or damage to the intestinal mucosal barrier [184], These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis. 

Cuoco L, Montalto M, Jorizzo RA, Santarelli L, Arancio F, Cammarota G, Gasbarrini G Eradication of small intestinal bacterial overgrowth and oro-cecal transit in diabetics. He-patogastroenterology 2002 49 1582-1586. 

Bouhnik Y, Alain S, Attar A, Flourie B, Ras-kine L, Sanson-Le Pors MJ, Rambaud JC Bacterial populations contaminating the upper gut in patients with small intestinal bacterial overgrowth syndrome. Am J Gastroenterol 1999 94 1327-1331. 

Guarner C, Runyon BA, Young S, Heck M, Sheikh MY Intestinal bacterial overgrowth and bacterial translocation in an experimental model of cirrhosis in rats. J Hepatol 1997 26 1372-1378. 

Corazza GR, Ventrucci M, Strocchi A, Sorge M, Pranzo L, Pezzilli R, Gasbarrini G Treatment of small intestine bacterial overgrowth with rifaximin, a non-absorbable rifamycin. J Int Med Res 1988 16 312-316. 

As outlined in the excellent review by Gilles and Brogden [9], the current indications for rifaximin include surgical prophylaxis and the treatment of hepatic encephalopathy, infectious diarrhea and intestinal bacterial overgrowth syndromes. As such, rifaximin is aimed only at enteric flora. Owing to its lack of absorption, rifaximin will likely not be used for other conditions or indications. Such limited indications should help preserve the activity of the agent, since overuse for common conditions like urinary or respiratory tract infections will naturally not occur. Limited use should help retard the development of resistance among enteric flora. 

Treatment of Small Intestine Bacterial Overgrowth and Related Symptoms by Rifaximin... 

Rifaximin Small intestine bacterial overgrowth Therapy Nonabsorbable antibiotics... 

The treatment of small intestine bacterial overgrowth (SIBO) is a clinical challenge for physicians, as data contained in the peer review literature do not offer conclusive... 

Su J, Smith MB, Rerknimitr R, Morrow D Small intestine bacterial overgrowth presenting as protein-losing enteropathy. Dig Dis Sci 1998 43 679-681. 

Banwell JG, Kistel LA, Giannella RA, Weber FL, Lieber A, Powell DE Small intestine bacterial overgrowth syndrome. Gastroenterology 1981 80 834-845. 

Di Stefano M, Malservisi S, Veneto G, Ferrieri A, Corazza GR Rifaximin versus chlortetracy-cline in the short-term treatment of small intestine bacterial overgrowth. Aliment Pharmacol Ther 2000 14 551-556. 

Trespi E, Ferrieri A Intestinal bacterial overgrowth during chronic pancreatitis. Curr Med ResOpin 1999,15 47-52. 

Attar A, Flourie B, Rambaud JC, Franchisseur C, Ruszniewski P, Bouhnik Y Antibiotic efficacy in small intestinal bacterial overgrowth-related chronic diarrhea A crossover, randomized trial. Gastroenterology 1999 i 17 794— 797. 

Di Stefano M, Pezzimenti D, Veneto G, Missa-nelli A, Corazza GR Absorbable vs. nonabsorbable antibiotics in the therapy of small intestine bacterial overgrowth (SIBO) in patients with blind loop syndrome. Dig Liver Dis 2001 33 A93. 

Pimentel H, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol 2000 95 3503-3506. 

Process for treating small intestine bacterial overgrowth in animals Patent number US57766524 (1998)... 

Small intestinal bacterial overgrowth 50 mg s.c. q.d. for 3 weeks VIPoma-associated diarrhea 150-750 meg s.c./i.v. divided in b.i.d.-q.i.d. dose for 2 weeks, then titrate for response... 

Small intestinal bacterial overgrowth 400 mg p.o. t.i.d. for 2 weeks. Therapy may be repeated if required... 

Patients with liver disease may have an increased gastrointestinal transit time [3]. These patients may benefit from taking a pro-kinetic agent, as normalisation of gastrointestinal motility will reduce the time available for the absorption of nitrogenous compounds that may precipitate encephalopathy. The use of pro-kinetic agents has also been shown to reduce intestinal bacterial overgrowth in patients with cirrhosis [4-6]. 

Pardo A, Bartoli R, Lorenzo-Zuniga V, et al. (2000) Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis. Hepatology 31 858-863. 

Loperamide is a narcotic agonist acting on opioid JL receptors. Loperamide has mild antisecretory effects but its primary effects are to increase segmental intestinal contractions and slow the propulsion of intestinal contents (Ruppin 1987). Loperamide has been associated with reduction in diarrhea in many clinical studies in humans but has minimal impact on the patient s fluid and electrolyte balance because the secreted fluid remains in the bowel lumen. Loperamide can have dose-dependent CNS depressant effects. Loperamide also has been shown to promote intestinal bacterial overgrowth because of promoting the retention of fluid within bowel segments (Duval-Iflah et al 1999), which may favor the proliferation of enteropathogenic bacteria. 

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