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- W2911649304 abstract "Introduction: Colectomy affects the anatomical structures of the gastrointestinal tract that may make patients more susceptible to certain motility disorders such as microbial overgrowth. The purpose of this investigation was to determine if colectomy is significantly associated with development of small intestinal bacterial (SIBO) or fungal (SIFO) overgrowth. Methods: A cohort of patients with unexplained chronic GI symptoms and a history colectomy were compared against a similar cohort of patients without colectomy. All patients had undergone negative GI evaluations (including endoscopy and abdominal imaging). SIBO/SIFO was determined by using either glucose breath testing or distal duodenal aspiration with culture for aerobic, anaerobic, and fungal organisms. Data were compared between the two groups. Results: One hundred patients were identified, of which 50 (m/f=9/41) had undergone colectomy and 50 (m/f=38/12) had intact colon. Mean patient age was 51.1 years (range: 17-88), 79% females, and a mean duration of symptoms of 6.5 years, and no difference between groups. In the colectomy group, the most frequent type of resection was partial (N=28), followed by subtotal (N=11), and total (N=11) colectomy respectively. Patients who had undergone prior colectomy were significantly more likely to have SIBO (62% vs 32%; P=0.0005) or SIFO (42% vs 12%; P=0.004) when compared to controls without colectomy. Culture aspirate testing revealed significantly greater predominance of aerobic organisms (45% vs 17%; P=0.008) in patients with colectomy, including primarily Streptococcus, Escherichia coli, Klebsiella pneumoniae, and fungal Candida species. Colectomy was also associated with greater gastrointestinal symptom severity including diarrhea (4.6 vs 3.0; P=0.029) and vomiting (2.5 vs 0.3; P<0.001) as assessed by the Likert scale. Also in the colectomy group, patients had significantly greater severity of belching (1.0 vs 0.0; P<0.001) and gas (5.5 vs 3.0; P=0.028) compared to those without. Conclusion: We found significantly higher prevalence of SIBO and SIFO in patients with unexplained GI symptoms following colectomy when compared to matched control group. The neo-anastomosis between the small and large bowel breaks down natural barriers that prevent translocation of bacteria from the colon, thereby leading to colonization and development of SIBO/SIFO. Appropriate recognition and treatment with antibiotics could help many of these patients.Figure" @default.
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- W2911649304 date "2017-10-01" @default.
- W2911649304 modified "2023-09-27" @default.
- W2911649304 title "Colectomy Is Significantly Associated With the Development of SIBO and SIFO" @default.
- W2911649304 doi "https://doi.org/10.14309/00000434-201710001-00162" @default.
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