Small intestinal bacterial overgrowth in chronic pancreatitis.

Kapil Dev, Jamwal (2013) Small intestinal bacterial overgrowth in chronic pancreatitis. Masters thesis, Christian Medical College, Vellore.


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INTRODUCTION : The human small intestine is the site of digestion and absorption of major macro and micronutrients. Any abnormality which affects this part of bowel may lead to nutritional deficiencies as well as malabsorption syndrome. An important cause of malabsorption syndrome is Small Intestinal bacterial Overgrowth (SIBO). The bacterial count is extremely low in the stomach and small intestine. The normal count in stomach is 102-103 CFU/ml, in duodenum is 103 CFU/ml, in jejunum the count is < 104 CFU/ml and in ileum it’s upto 107-109 CFU/ml. SIBO (small intestinal bacterial overgrowth) is defined as increased bacterial counts in the proximal small bowel ( jejunum and ileum). It is also defined as the replacement of normal small bowel bacteria with the colonic bacteria. SIBO is diagnosed by jejunal aspiration (gold standard) and various breath tests ( Hydrogen breath tests, C breath tests, lactulose breath tests, methane breath tests etc. ) The clinical manifestations of SIBO may range from asymptomatic stage to malabsorption syndrome. Chronic pancreatitis has been defined as a clinical condition associated with morphological (fibrosis/calcification) of pancreas and/ or functional (exocrine and endocrine) insufficiency of the pancreas. SIBO has been reported in chronic pancreatitis and may be due to drugs (Proton pump inhibitors / analgesics), deficiency of pancreatic enzymes, impaired small bowel motility or surgery. AIMS : 1. To determine the frequency of SIBO (Small intestinal bacterial overgrowth) in chronic pancreatitis. 2. To evaluate the sensitivity and specificity of GHBT (Glucose Hydrogen Breath Test) in SIBO (Small intestinal bacterial overgrowth) by comparing it to jejunal aspirate culture (Gold standard). CONCLUSION : SIBO was not uncommon in patients with chronic pancreatitis. SIBO was diagnosed in 1/3rd of patients with chronic pancreatitis.. GHBT can be used for diagnosis of SIBO and with a sensitivity of 62% and a specificity of 92% respectively.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Small intestinal bacterial ; overgrowth ; chronic pancreatitis.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 14 Jul 2017 06:18
Last Modified: 14 Jul 2017 06:18

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