Skip to main content

Advertisement

SpringerLink
Log in

Small Intestinal Clustered Contractions and Bacterial Overgrowth: A Frequent Finding in Obese Patients

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Small intestinal bacterial overgrowth (SIBO) has been observed in several disorders of the gastrointestinal tract. Studies have shown abnormalities of motor function in obese patients, and there is indirect evidence suggesting that SIBO is present in them.

Aims

To study small intestinal motility and the prevalence of SIBO in obese patients and to determine whether there was any relationship between both parameters.

Methods

Thirty-nine patients scheduled for bariatric surgery were subjected to hydrogen breath test with lactulose and to a stationary small intestinal motility study with perfused catheters.

Results

SIBO was observed in 41% of obese patients and was not related to body mass index. Small intestinal manometry showed a marked increase of clustered contractions in obese patients with SIBO compared to obese subjects without SIBO, whereas all the other parameters of fasting cyclic activity were not different.

Conclusions

SIBO was a frequent finding in obese patients and was associated with an increased pattern of clustered contractions, which was not observed in absence of SIBO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bishop R, Anderson CM. The bacterial flora of the stomach and small intestine in children with intestinal obstruction. Arch Dis Child. 1960;35:487–491.

    Article  PubMed  Google Scholar 

  2. Di Stefano M, Miceli E, Missanelli A, Mazzocchi S, Corazza GR. Absorbable vs. non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome. Aliment Pharmacol Ther. 2005;21:985–992.

    Article  CAS  PubMed  Google Scholar 

  3. Skar V, Skar AG, Osnes M. The duodenal bacterial flora in the region of papilla of Vater in patients with and without duodenal diverticula. Scand J Gastroenterol. 1989;24:649–656.

    Article  CAS  PubMed  Google Scholar 

  4. Vantrappen C, Janssens J, Hellemans J, Ghoos Y. The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. Interdigestive motor complex and small intestinal bacterial overgrowth. J Clin Invest. 1997;59:1158–1166.

    Article  Google Scholar 

  5. Stotzer PO, Björnsson ES, Abrahamsson H. Interdigestive and postprandial motility in small intestinal bacterial overgrowth. Scand J Gastroenterol. 1996;31:875–880.

    Article  CAS  PubMed  Google Scholar 

  6. Vincent B, Nieuwenhuijs MD, Verheem A, et al. The role of interdigestive small bowel motility in the regulation of gut microflora, bacterial overgrowth, and bacterial translocation in rats. Ann Surg. 1998;228:188–193.

    Article  Google Scholar 

  7. Chesta J, Defilippi Cl, Defilippi C. Abnormalities in proximal small bowel motility in patients with cirrhosis. Hepatology. 1993;17:828–832.

    CAS  PubMed  Google Scholar 

  8. Madrid AM, Cumsille F, Defilippi C. Altered small bowel motility in patients with liver cirrhosis depends on severity of liver disease. Dig Dis Sci. 1997;42:738–742.

    Article  CAS  PubMed  Google Scholar 

  9. Paerregaard A, Justesen T, Prytz H, Anderson B, Gudmand-Höyer E. Metronidazole treatment of bypass-enteropathy after jejunoileal shunt-operation for obesity. Acta Chir Scand. 1982;148:153–156.

    CAS  PubMed  Google Scholar 

  10. Passaro E Jr, Drenick E, Wilson SE. Bypass enteritis. A new complication of jejunoileal bypass for obesity. Am J Surg. 1976;131:169–174.

    Article  PubMed  Google Scholar 

  11. Nair S, Cope K, Terence RH, Mae A. Obesity and female gender increase breath ethanol concentration: potential implications for the pathogenesis of nonalcoholic steatohepatitis. Am J Gastroenterol. 2001;96:1200–1204.

    Article  CAS  PubMed  Google Scholar 

  12. Cope K, Risby T, Diehl AM. Increased gastrointestinal ethanol production in obese mice: implications for fatty liver disease pathogenesis. Gastroenterology. 2000;119:1340–1347.

    Article  CAS  PubMed  Google Scholar 

  13. Konturek PC, Konturek JW, Czesnikiewicz-Guzik M, Brzozowski T, Sito E, Konturek SJ. Neuro-hormonal control of food intake; basic mechanisms and clinical implications. J Physiol Pharmacol. 2005;56:5–25.

    Google Scholar 

  14. Tack J, Depoortere I, Bisschops R, et al. Influence of ghrelin on interdigestive gastrointestinal motility in humans. Gut. 2006;55:327–333.

    Article  CAS  PubMed  Google Scholar 

  15. Suematsu M, Katsuki A, Sumida Y, et al. Decreased circulating levels of active ghrelin are associated with increased oxidative stress in obese subjects. Eur J Endocrinol. 2005;153:403–407.

    Article  CAS  PubMed  Google Scholar 

  16. Xing J, Chen JDZ. Alterations of gastrointestinal motility in obesity. Obes Res. 2004;12:1723–1732.

    Article  PubMed  Google Scholar 

  17. Tosetti C, Corinaldesi R, Stanghellini V, et al. Gastric emptying of solids in morbid obesity. Int J Obes Relat Metab Disord. 1996;20:200–205.

    CAS  PubMed  Google Scholar 

  18. McCallum RW, Jones TF, Lin Z, Sarosiek I, Moncure M. Assessment of gastric emptying, myoelectric activity in the morbidly obese patient. Gastroenterology. 2001;120:A-290.

    Google Scholar 

  19. Basilisco G, Camboni G, Bozzani A, Vita P, Doldi S, Bianchi PA. Orocecal transit delay in obese patients. Dig Dis Sci. 1989;34:509–512.

    Article  CAS  PubMed  Google Scholar 

  20. Wisen O, Johansson C. Gastrointestinal function in obesity: motility, secretion, and absorption following a liquid test meal. Metabolism. 1992;41:390–395.

    Article  CAS  PubMed  Google Scholar 

  21. French SJ, Murray B, Rumsey RD, Sepple CP, Read NW. Preliminary studies on the gastrointestinal responses to fatty meals in obese people. Int J Obes Relat Metab Disord. 1993;17:295–300.

    CAS  PubMed  Google Scholar 

  22. Pieramico O, Malfertheiner P, Nelson DK, Glasbrenner B, Ditschuneit H. Interdigestive gastroduodenal motility and cycling of putative regulatory hormones in severe obesity. Scand J Gastroenterol. 1992;27:538–544.

    Article  CAS  PubMed  Google Scholar 

  23. Simrén M, Stotzer P-O. Use and abuse of hydrogen breath test. Gut. 2006;55:291–303.

    Article  Google Scholar 

  24. Summers RW, Anuras S, Green J. Jejunal manometry patterns in health, partial intestinal obstruction, and pseudoobstruction. Gastroenterology. 1983;85:1290–1300.

    CAS  PubMed  Google Scholar 

  25. Madrid AM, Hurtado C, Venegas M, Cumsille F, Defilippi C. Long-term treatment with cisapride and antibiotics in liver cirrhosis: effect on small intestinal motility, bacterial overgrowth, and liver function. Am J Gastroenterol. 2001;96:1251–1255.

    Article  CAS  PubMed  Google Scholar 

  26. Madrid AM, Brahm J, Buckel E, Silva G, Defilippi C. Orthotopic liver transplantation improves small bowel motility disorders in cirrhotic patients. Am J Gastroenterol. 1997;92:1044–1045.

    CAS  PubMed  Google Scholar 

  27. Kellow JE, Phillips SF. Altered small bowel motility in irritable bowel syndrome is correlated with symptoms. Gastroenterology. 1987;92:1885–1893.

    CAS  PubMed  Google Scholar 

  28. Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol. 2000;95:3503–3506.

    Article  CAS  PubMed  Google Scholar 

  29. Pimentel M, Chow EJ, Lin HC. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome, a double-blind, randomized, placebo-controlled study. Am J Gastroenterol. 2003;98:412–419.

    PubMed  Google Scholar 

  30. Posserud I, Stotzer P-O, Björnosson ES, Abrahamsson H, Simrén M. Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut. 2007;56:802–808.

    Article  PubMed  Google Scholar 

  31. Schmidt T, Eberle R, Pfeiffer A, Kaess H. Effect of ethanol on postprandial duodenojejunal motility in humans. Dig Dis Sci. 1997;42:1628–1633.

    Article  CAS  PubMed  Google Scholar 

  32. Bäckhned F, Ding H, Wang T, et al. The gut microbiota as an environmental factor that regulates fat storage. PNAS. 2004;101:15718–15723.

    Article  Google Scholar 

  33. Bäckhned F, Manchester JK, Semenkovich CF, Gordon JI. Mechanisms underlying the resistance to diet-induced obesity in germ-free mice. PNAS. 2007;104:979–984.

    Article  Google Scholar 

  34. Vanner S. The small intestinal bacterial overgrowth. Irritable bowel syndrome hypothesis: implications for treatment. Gut. 2008;57:1315–1321.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Dr. Eamonn M. Quigley, for his careful review of this manuscript.

Author information

Authors and Affiliations

  1. Section of Gastroenterology, University Hospital of University of Chile, University of Chile, Santos Dumont 999, Santiago, Chile

    Ana María Madrid, Jaime Poniachik, Rodrigo Quera & Carlos Defilippi

Authors
  1. Ana María Madrid
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jaime Poniachik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rodrigo Quera
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carlos Defilippi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana María Madrid.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Madrid, A.M., Poniachik, J., Quera, R. et al. Small Intestinal Clustered Contractions and Bacterial Overgrowth: A Frequent Finding in Obese Patients. Dig Dis Sci 56, 155–160 (2011). https://doi.org/10.1007/s10620-010-1239-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-010-1239-9

Keywords

Search

Navigation