This article is more than 5 years old. Information may no longer be current.
Cholecystectomy patients less likely to develop small intestinal bacterial overgrowth
Click Here to Manage Email Alerts
LAS VEGAS — Cholecystectomy may protect against overgrowth of small intestinal bacteria, according to data presented at the 2012 of Gastroenterology Annual Scientific Meeting.
In a retrospective chart review, researchers evaluated demographic data and medical and surgical histories of 196 patients who received lactulose breath testing (LBT) for 24 months. LBT results indicating small intestinal bacterial overgrowth (SIBO) were defined according to the following criteria:
- Baseline hydrogen levels greater than 20 ppm
- A hydrogen increase of more than 20 ppm within 60 minutes
- Baseline methane levels greater than 40 ppm
- A methane increase of more than 10 ppm within 60 minutes
- Fulfillment of all criteria
“Animal studies have demonstrated significant antimicrobial effects of conjugated bile acids in the distal small intestine; however, there is currently no published literature examining the relationship between cholecystectomy and SIBO,” the researchers wrote.
Nearly half of participants had positive LBT test results indicating SIBO (47.4%). Among 45 participants who had undergone cholecystectomy, 33.3% had positive results, compared with 51.7% among those who had not received cholecystectomy (P=.025). Investigators also noted a near-significant difference between the rate of positive results in the 34 patients who had previously undergone appendectomy compared to those who had not (52.9% vs. 46.9%, P=.52).
“Patients who have a history of previous cholecystectomy have lower rates of bacterial overgrowth, as diagnosed by a lactulose breath test,” researcher Scott L. Gabbard, MD, advanced esophageal and motility fellow at in , told Healio.com. “In patients who have had a cholecystectomy with symptoms that could be consistent with bacterial overgrowth, maybe clinicians should think about alternative causes before going toward a breath test, because they clearly have lower rates of overgrowth.”
Gabbard said clinical ramifications of the research remain unseen, but the results contribute to the knowledge of bacterial overgrowth risk factors. “This is an interesting first step, and may add to our understanding of bacterial overgrowth and the microflora of the digestive tract,” he said, adding further study with a larger group of patients would be beneficial.
For more information:
Gabbard SL. P711: Cholecystectomy May Be Protective Against Small Intestinal Bacterial Overgrowth. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.