Assessment of small intestinal bacterial overgrowth in chronic pancreatitis patients using jejunal aspirate culture and glucose hydrogen breath test. (4th May 2021)

• Record Type: Journal Article
• Authors: Sanjeevi, Rajesh; Jamwal, Kapil Dev; Dhar Chowdhury, Sudipta; Ramadass, Balamurugan; Gayathri, R.; Dutta, Amit Kumar; Joseph Joseph, Anjilivelil; Ramakrishna, Balakrishnan S.; Chacko, Ashok
• Is Part Of: Scandinavian journal of gastroenterology. Volume 56:Number 5(2021)
• Page Start: 588
• Page End: 593
• Publication Date: 2021-05-04
• Subjects: Small intestinal bacterial overgrowth -- jejunal aspirate culture -- glucose hydrogen breath test -- chronic pancreatitis -- pancreatic exocrine insufficiency; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2021.1900383
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Background: A subset of chronic pancreatitis patients respond poorly to pancreatic enzyme replacement therapy. Small intestinal bacterial overgrowth (SIBO) is considered to be one of the major reasons for this poor response. Previous studies have reported a wide range of prevalence of SIBO in patients with chronic pancreatitis. We aimed to assess the prevalence of SIBO in chronic pancreatitis using quantitative jejunal aspirate culture and glucose hydrogen breath test (GHBT). The sensitivity and specificity of GHBT for the diagnosis of SIBO in chronic pancreatitis were also estimated. Methods: Newly diagnosed chronic pancreatitis patients were recruited into the study. A detailed history and relevant laboratory tests were done. All patients underwent an endoscopy and jejunal fluid aspiration for bacterial cultures and GHBT to detect SIBO. The results of GHBT were compared with jejunal fluid aspirate culture. Results: The jejunal aspirate culture was positive in 18/48 (37.5%) patients while the GHBT showed that 14/48 (29%) patients had SIBO. The sensitivity, specificity, positive and negative predictive value of GHBT in our study was 44.4, 80, 57.14 and 70.59%, respectively. Conclusions: SIBO is not uncommon in chronic pancreatitis patients. One-third of our study population had SIBO. GHBT has low sensitivity but had high specificity in the diagnosis of SIBO in chronic pancreatitis.