The syndrome of bacterial overgrowth in children with chronic gastritis
Background. Achlorhydria of any origin may be one of the main causes of bacterial overgrowth syndrome (BOS). The data on this controversial issue, some researchers argue the association of long-term use of proton pump inhibitors (PPI) with BOS development. The purpose was to study the clinical manifestations and the state of microbiota of the upper intestine in children with chronic gastritis and reduced gastric function. Materials and methods. The study involved 65 children with chronic gastritis (CG), aged 7–18 years. The study methods included esophasogastroduodenoscopy, biopsy of the gastric mucosa for H. pylori, pH-meter; ultrasound investigation of the abdominal cavity. Mucosa morphological changes were assessed by visual analogue scale. A hydrogen breath test (HBT) using the analyzer Gastrolyzer load lactulose was performed in all patients in order to verify BOS. The results were presented by the number of observations mean values and their standard deviation and error (M ± m for p < 0.05), relative frequency (%). Results. Of the 65 examined children suffering from CG, 27 persons had hypoacidy hastritis, the average pH was 4.7 ± 0.4. Seventeen children with CG had gastroesophageal reflux (GER). In both groups of patients symptoms of diarrhea and flatulence dominated, but in patients with GER receiving PPIs prevalence and severity of symptoms deteriorated with increasing duration of therapy. The study found that H. pylori infection was registered in 42 (64.6 %) of all children with CG. The HBT results demonstrated that more than a third (44.4 %) patients had BOS. In children with CG combined with GER positive HBT was registered in 41.1 % cases. The BOS incidence in these patients was found to enhance with increasing duration of PPI intake. Conclusions. A high incidence of complaints related to the BOS development was found in children with hypoacid CG and in patients with GER treated with PPIs. BOS in patients with CG and patients who have been treated with PPIs, was verified by HBT (44.4 % and 41.1 %, respectively).
Full Text:PDF (Українська)
Gill SR, Pop M, Deboy RT, Eckburg PB, Turnbaugh PJ, Samuel BS, Gordon JI, Relman DA, Fraser-Liggett CM, Nelson KE. Metagenomic analysis of the human distal gut microbiome. Science. 2006 Jun 2;312(5778):1355-9. doi:10.1126/science.1124234.
Sanders ME, Guarner F, Guerrant R, Holt PR, Quigley EM, Sartor RB, et al. An update on the use and investigation of probiotics in health and disease. Gut 2013;62(5):787-96. doi: 10.1136/gutjnl-2012-302504.
Spiegel BM, Chey WD, Chang L. Questioning the bacterial overgrowth hypothesis of irritable bowel syndrome: an epidemiologic and evolutionary perspective. Clin. Gastroenterol Hepatol. 2011;9(6):461-9. doi: 10.1016/j.cgh.2011.02.030.
Ershova IB, Mochalova AA, Osipova TF, Rezchikov VA. Topical issues of joint use of antibacterial drugs and probiotics. Aktualnaya infektologiya. 2015;3(8):25-30. (In Russian). doi: 10.22141/2312-413x.3.08.2015.78696.
Ratuapli SK, Ellington TG, O'Neill MT, Umar SB, Harris LA, Foxx-Orenstein AE, Burdick GE, Dibaise JK, Lacy BE, Crowell MD. Proton pump inhibitor therapy use does not predispose to small intestinal bacterial overgrowth. Am J Gastroenterol. 2012;107(5):730-5. doi: 10.1038/ajg.2012.4.
Lombardo L, Foti M, Ruggia O, Chiecchio A. Increased incidence of small intestinal bacterial overgrowth during proton pump inhibitor therapy. Clin Gastroenterol Hepatol. 2010;8(6):504-8. doi: 10.1016/j.cgh.2009.12.022.
Copyright (c) 2017 ACTUAL INFECTOLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018