Diabetic neuropathy often results in dysmotility of the gastrointestinal tract that induces further changes in its microbiotic spectrum. This can influence the course of concomitant diseases not related to diabetes mellitus and determine the effectiveness of their treatment. Aim: to investigate the effectiveness of anti-Helicobacter therapy in patients with chronic gastritis and concomitant type 2 diabetes, considering small intestinal bacterial overgrowth syndrome. Materials and methods: 64 patients with chronic Helicobacter pylori-positive gastritis were examined, 34 out of them had type 2 diabetes mellitus. Pantoprazole 40 mg, clarithromycin 500 mg, amoxicillin 1000 mg bid were prescribed to all the patients for 10 days. Before the treatment, on the 14th and 28th days of the therapy, a hydrogen breath test with lactulose to reveal small intestinal bacterial overgrowth, gastrointestinal symptoms monitoring, and re-determining Helicobacter pylori focal antigen on 28th day were performed. Results: on the 14th day of the treatment a decrease in the pain syndrome (n=28, 93% vs. n=10, 33%; p> 0.05), postprandial fullness (n=14, 47% vs. n = 4, 13% p>0.05) and nausea (n=13, 43% vs. n=4, 13% p>0.05) was observed among the non-diabetic patients with chronic gastritis. No statistical significance regarding abdominal pain regressing in patients with type 2 diabetes mellitus was found (n=16, 47% vs. n=9, 26%), postprandial fullness did not change noticeably (n=27, 79% vs. n=26, 76%), while the frequency of nausea increased (n=14, 41% vs. n=18, 53%). The incidence of small intestinal bacterial overgrowth significantly increased compared with the data before the therapy (n=16, 47% vs. n=27, 79%; p>0.05) and with non-diabetic patients (n = 15, 50% vs. n = 27,79%; p> 0.05). The effectiveness of H. pylori therapy was higher among patients without diabetes mellitus (77% vs. 65%). Conclusions: it has been found out anti-Helicobacter therapy is less effective in the patients with chronic gastritis and concomitant type 2 diabetes mellitus that is accompanied by the enhancement of bacterial overgrowth syndrome and associated with worse clinical dynamics compared to patients without carbohydrate metabolism disorders.
Small intestinal bacterial overgrowth syndrome in children with idiopathic nephritic syndrome treated with immunosuppressive agents
