scholarly journals Dysmotility and proton pump inhibitor use are independent risk factors for small intestinal bacterial and/or fungal overgrowth

2013 ◽  
Vol 37 (11) ◽  
pp. 1103-1111 ◽  
Author(s):  
C. Jacobs ◽  
E. Coss Adame ◽  
A. Attaluri ◽  
J. Valestin ◽  
S. S. C. Rao
2021 ◽  
Vol 8 ◽  
Author(s):  
Shanshan Sun ◽  
Wenyi Ye ◽  
Ruihong Zhao ◽  
Jianhua Hu ◽  
Xuan Zhang ◽  
...  

Background: The aim of this study was to investigate the impact of proton pump inhibitor (PPI) therapy on complications and prognosis in cirrhosis patients with and without acute-on-chronic liver failure (ACLF).Materials and Methods: Cirrhosis patients with acute decompensation (AD) (n = 489) admitted in our center were enrolled in this prospective observational cohort study. According to treatment received, patients were identified as users or nonusers of PPI. Clinical and laboratory data, complications during hospitalization, and overall survival were recorded in all the patients.Results: Of the 489 patients, 299 (61.1%) patients received PPI therapy. The logistic regression analysis showed that age, albumin, history of previous hepatic encephalopathy (HE), and the chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score were independent risk factors for HE in patients with decompensated cirrhosis [odds ratio (OR) = 1.07, 95% CI: 1.03–1.12, p = 0.001; OR = 1.13, 95% CI: 1.04–1.24, p = 0.006; OR = 242.52, 95% CI: 40.17–1464.11, p < 0.001; and OR = 2.89, 95% CI: 2.11–3.96, p < 0.001, respectively]. Previous severe liver injury and previous bacterial infections were independent risk factors for spontaneous bacterial peritonitis (SBP) in patients with decompensated cirrhosis (OR = 3.43, 95% CI: 1.16–10.17, p = 0.026 and OR = 6.47, 95% CI: 2.29–18.29, p < 0.001, respectively). The multivariate Cox proportional hazards regression model showed that the type and dose of the PPI used were not related to 28-day and 90-day mortality in cirrhosis patients with AD or ACLF.Conclusion: PPI use does not appear to increase mortality or the risk of HE and SBP in the hospitalized cirrhosis patients with and without ACLF.


2014 ◽  
Vol 2 (1) ◽  
pp. 18-24
Author(s):  
Sung-Shuo Kao ◽  
Deng-Chyang Wu ◽  
Seng-Kee Chuah ◽  
Chao-Hung Kuo ◽  
Ching-Liang Lu ◽  
...  

2009 ◽  
Vol 136 (5) ◽  
pp. A-684 ◽  
Author(s):  
Yukiko Yoda ◽  
Kazuhide Higuchi ◽  
Koji Takeuchi ◽  
Eiji Umegaki ◽  
Satoshi Tokioka ◽  
...  

2017 ◽  
Vol 26 (4) ◽  
pp. 363-368 ◽  
Author(s):  
Akihiro Shimozato ◽  
Makoto Sasaki ◽  
Naotaka Ogasawara ◽  
Yasushi Funaki ◽  
Masahide Ebi ◽  
...  

Background & Aims: With improved technology, the size of artificial ulcers after endoscopic submucosal dissection (ESD) has increased. The aim of our study was to examine the risk factors for delayed gastric ulcer healing after ESD, including the possible benefit of potassium-competitive acid blocker (P-CAB) treatment.Methods: The primary outcome was the rate of healing of the artificial ulcers induced by ESD at 8 weeks post intervention. Design: retrospective case series. Setting: Aichi Medical University Hospital. Patients: patients who underwent ESD for gastric neoplasm, between April 2015 and March 2017. Intervention: ESD, with a follow-up endoscopic examination at 8 weeks post-ESD. Univariate and multivariate analyses were used to identify the independent risk factors for delayed healing.Results: Of the 73 gastric neoplasms included in the analysis, delayed ulcer healing was identified in 21.9%. Dyslipidemia (p=0.04), ESD procedure time (p=0.003) and artificial ulcer size (p<0.001) were identified as risk factors for delayed healing, with location in the lower third of the stomach [Odds ratio (OR) 6.76; p=0.016] and artificial ulcer size (OR, 1.18; p=0.024) retained as independent risk factors. A cut-off ulcer size of 854 mm2 was predictive of delayed healing, with a sensitivity of 29.8% and specificity of 87.5%. For large ulcers, the rate of healing of 70% with vonoprazan was higher than the rate of 47.6% with proton pump inhibitors (PPIs), although this difference was not significant.Conclusion: For artificial ulcers after ESD with a resection diameter >35 mm, it might be desirable to use PPIs for >8 weeks or P-CAB.Abbreviations: EGC: early gastric cancers; EMR: endoscopic mucosal resection; ESD: endoscopic submucosal dissection; H. pylori: Helicobacter pylori; H2RA: H2-receptor antagonist: PRP: platelet rich plasma; PGA: polyglycolic acid; P-CAB: potassium-competitive acid blocker; PPI: proton pump inhibitor.


2012 ◽  
Vol 153 (33) ◽  
pp. 1287-1293 ◽  
Author(s):  
József Hamvas

There are several causes of small bowel contamination. The effects of the long-term proton pump inhibitor treatment on the development of bowel symptoms and/or small intestinal bacterial overgrowth have been highlighted only in the past decade. The main diagnostic method is the hydrogen breath test that gives quantitative results with a simple, non-invasive procedure. There is a limited number of publications in the literature about the effects of proton pump inhibitor drugs on bowel bacterial milieau. Our results based on the investigations of two medical centres in Budapest show consistency with international data: the positive hydrogen breath test was present in 21% of the population using long-term proton pump inhibitors. In uncomplicated cases, symptom-free condition could be reached with probiotics, whereas in long lasting, chronic small intestinal bacterial overgrowth, antibiotic treatment should be considered. Rifaximin, a non-absorbable antibiotic showed high efficacy in the treatment of small intestinal bacterial overgrowth, with fewer side effects compared to systemic antibiotics. Orv. Hetil., 2012, 153, 1287–1293.


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