scholarly journals Cronkhite-Canada Syndrome: A Rare Cause of Chronic Diarrhoea in a Young Man

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Dhrubajyoti Bandyopadhyay ◽  
Adrija Hajra ◽  
Vijayan Ganesan ◽  
Suvrendu Sankar Kar ◽  
Debarati Bhar ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Bacterial Overgrowth ◽  
Close Correlation ◽  
Small Intestinal Bacterial Overgrowth ◽  
Clinical Findings ◽  
Careful Examination ◽  
Chronic Diarrhoea ◽  
History Of ◽  
Clostridium Difficile Toxin ◽  
Colon And Rectum

A young Indian man presented with nine-month history of chronic diarrhea, occasionally mixed with blood and intermittent colicky abdominal pain. He also complained of generalized body swelling for the last three months. On examination, he had diffuse hyperpigmentation of the skin and dystrophic nail changes. Upper and lower gastrointestinal endoscopy revealed multiple sessile polyps in the stomach, small bowel, and colon and rectum. Biopsy of polyps showed adenomatous changes with stromal edema and dilated glands. Cronkhite-Canada syndrome (CCS) was diagnosed and treated with glucocorticoids and enteral nutritional supplementation. There was an associated small intestinal bacterial overgrowth (SIBO) and stool was positive for clostridium difficile toxin. After 12 weeks of treatment, the patient achieved remission. Close correlation with clinical findings, including pertinent ectodermal abnormalities, endoscopic studies, and careful examination of biopsies will ensure a timely and correct diagnosis of CCS.

scholarly journals The Influence of Small Intestinal Bacterial Overgrowth in Digestive and Extra-Intestinal Disorders

2020 ◽  
Vol 21 (10) ◽  
pp. 3531 ◽  
Author(s):  
Giuseppe Losurdo ◽  
Fulvio Salvatore D’Abramo ◽  
Giuseppe Indellicati ◽  
Chiara Lillo ◽  
Enzo Ierardi ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Calcium Deficiency ◽  
Watery Diarrhea ◽  
Irritable Bowel Disease ◽  
Intestinal Bacterial Overgrowth ◽  
History Of ◽  
Small Intestinal ◽  
Irritable Bowel

Small intestinal bacterial overgrowth (SIBO) is a condition hallmarked by an increase in the concentration of colonic-type bacteria in the small bowel. Watery diarrhea, bloating, abdominal pain and distension are the most common clinical manifestations. Additionally, malnutrition and vitamin (B12, D, A, and E) as well as minerals (iron and calcium) deficiency may be present. SIBO may mask or worsen the history of some diseases (celiac disease, irritable bowel disease), may be more common in some extra-intestinal disorders (scleroderma, obesity), or could even represent a pathogenetic link with some diseases, in which a perturbation of intestinal microbiota may be involved. On these bases, we performed a review to explore the multiple links between SIBO and digestive and extra-intestinal diseases.

Bariatric Surgery and Its Complications in Inflammatory Bowel Disease Patients

2019 ◽  
Author(s):  
Amandeep Singh ◽  
Brian Koenen ◽  
Donald F Kirby
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Management Strategies ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Underlying Disease ◽  
Life Outcomes ◽  
High Prevalence ◽  
History Of ◽  
Inflammatory Bowel

Abstract Recent data have suggested that bariatric procedures, especially laparoscopic sleeve gastrectomy (SG), are safe and effective weight loss measures in patients with inflammatory bowel disease (IBD). But most of the studies have looked at short-term outcomes, and there is a general lack of awareness of underlying disease processes and baseline comorbidities in IBD patients undergoing bariatric procedures. Postbariatric issues in IBD patients including diarrhea from dumping syndrome, choleretic diarrhea, a high prevalence of small intestinal bacterial overgrowth, gastroesophageal reflux disease, Barrett’s esophagus, stomal ulcerations, stenosis, and renal and gallstones can complicate the natural history of IBD. This could lead to unnecessary hospitalizations, change of medical therapy, and poor surgical and quality of life outcomes. In this review, we will discuss major complications after common bariatric procedures (SG, Roux-en-Y gastric bypass, and gastric banding) and suggest possible management strategies.

scholarly journals Pneumatosis coli in a dog – a serial radiographic study: a case report

2016 ◽  
Vol 61 (No. 7) ◽  
pp. 404-408 ◽  
Author(s):  
TS Hwang ◽  
YM Yoon ◽  
SA Noh ◽  
DI Jung ◽  
SC Yeon ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Bacterial Overgrowth ◽  
Pneumatosis Coli ◽  
Colon Wall ◽  
Computed Tomographic ◽  
Faecal Culture ◽  
Abdominal Radiographs ◽  
History Of ◽  
Colon And Rectum ◽  
Intramural Gas

A 12-year-old intact female poodle was presented with a history of an acute episode of tenesmus and passage of ribbon-shaped stools. Anaemia, leucocytosis, hypoalbuminaemia, hyperglycaemia, and elevated ALP were found. Faecal floatation and wet mount preparation were negative for parasites. Anaerobic faecal culture resulted in a heavy growth of Clostridium. Survey abdominal radiographs revealed extensive intramural emphysema of colon and rectum. Ultrasonography of the abdomen revealed bright echoes within the layers of the colon wall, confirming the accumulation of intramural gas. Abdominal computed tomography revealed extraluminal gas tracking along the colon and the rectum. Based on the radiographic, ultrasonographic, and computed tomographic findings, the present case was diagnosed as pneumatosis coli with an underlying cause of bacterial overgrowth. The patient was treated with antibiotics for seventeen days. Clinical signs were resolved after three days of treatment. Decreased intramural gas accumulation was evident during radiography of the abdomen performed at fourteen days after the initial evaluation. Therefore, pneumatosis coli should be considered when a dog is presented with clinical signs of colitis.

D-lactic acidosis presenting as metabolic encephalopathy in a patient with short bowel syndrome

2021 ◽  
Vol 14 (5) ◽  
pp. e241102
Author(s):  
Ciarán McHale ◽  
Eoin Keating ◽  
Helen O'Donovan ◽  
Eoin Slattery
Keyword(s):  
Lactic Acidosis ◽  
Short Bowel Syndrome ◽  
Management Strategies ◽  
Bacterial Overgrowth ◽  
Signs And Symptoms ◽  
Small Intestinal Bacterial Overgrowth ◽  
Metabolic Encephalopathy ◽  
Short Bowel ◽  
Current Therapies ◽  
History Of

We present a case of D-lactic acidosis presenting as a metabolic encephalopathy secondary to small intestinal bacterial overgrowth. This patient had a known history of short bowel syndrome. Of note, this case required the alteration of treatment to promote a sustained clinical and biochemical improvement. We discuss the pathophysiological mechanisms thought to be involved. We also review the current therapies as well as potential future strategies. This case highlights the importance of the prompt clinical recognition of signs and symptoms as well as the rapid initiation of management strategies to ameliorate this condition.

Small intestinal bacterial overgrowth in older people

2015 ◽  
Vol 25 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Syed Amer ◽  
Huma S Manzar
Keyword(s):  
Older People ◽  
Standard Treatment ◽  
Clinical Manifestations ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Underlying Disease ◽  
Chronic Diarrhoea ◽  
Multimodal Approach ◽  
Intestinal Bacterial Overgrowth ◽  
Small Intestinal

SummarySmall intestinal bacterial overgrowth (SIBO) is a condition in which non-native bacteria and/or native bacteria are present in increased numbers in the small bowel, resulting in excessive fermentation, inflammation or malabsorption. Patients with SIBO vary in presentation, from being only mildly symptomatic to suffering from chronic diarrhoea, weight loss and malabsorption. A number of diagnostic tests are currently available, with aspiration of the small intestinal fluid being the gold standard. Treatment encompasses a multimodal approach including treatment of the underlying disease, nutritional support and antibiotic therapy. In this review, we discuss the risk factors, clinical manifestations, diagnosis and treatment of SIBO in older people.

Small Intestinal Bacterial Overgrowth Is Associated with Non- Alcoholic Fatty Liver Disease

2016 ◽  
Vol 25 (2) ◽  
pp. 159-165 ◽  
Author(s):  
Andrea Fialho ◽  
Andre Fialho ◽  
Prashanthi Thota ◽  
Arthur J. McCullough ◽  
Bo Shen
Keyword(s):  
Risk Factors ◽  
Fatty Liver Disease ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Study Group ◽  
Alcoholic Fatty Liver ◽  
Intestinal Bacterial Overgrowth ◽  
Small Intestinal ◽  
Alcoholic Fatty Liver Disease

Background: Changes in gut bacteria play a role in type 2 diabetes mellitus (DM) and hepatic steatosis. There is a lack of studies evaluating the frequency and risk factors for non-alcoholic fatty liver disease (NAFLD) in patients tested for small intestinal bacterial overgrowth (SIBO). Aim: To evaluate the frequency of NAFLD and associated risk factors in patients tested for SIBO. Methods: In this case-control study, 372 eligible patients submitted to glucose hydrogen/methane breath test for SIBO who also had an abdominal imaging study were included. Patients were divided into SIBO-positive and SIBO-negative groups. Clinical, demographic and laboratory variables were evaluated in addition to the presence of NAFLD on abdominal imaging. Results: Of the 372 eligible patients, 141 (37.9%) were tested positive for SIBO (study group) and 231 (62.1%) were negative for it (control group). NAFLD occurred in 45.4% (64/141) of the study group compared to 17.3% (40/231) of the control group (p<0.001). Patients in the study group were found to have higher rates of elevated aspartate aminotransferase (AST) (20.6% vs. 11.3%; p=0.034) and alanine aminotransferase (ALT) levels (56.0% vs. 40.7%; p= 0.039), type 2 diabetes (23.4% vs. 13.9%; p=0.041), hypertension (54.6% vs. 40.3%; p=0.046) and metabolic syndrome (78.0% vs. 60.2%; p=0.020). In the multivariate analysis, SIBO (odds ratio [OR]: 1.95; 95% confidence interval [CI]: 1.14-3.31; p=0.014), type 2 DM (OR: 3.04; 95%CI: 1.57-5.90; p=0.001) and obesity (OR: 3.58; 95%CI: 1.70-7.54; p=0.001) remained associated with NAFLD.Conclusion: Patients with SIBO have an increased risk for hepatic steatosis and may benefit from aggressive control of the risk factors for NAFLD including metabolic syndrome. Abbreviations: ALT: alanine aminotransferase; AST: aspartate aminotransferase; BMI: body mass index; CTE: computed tomography enterography; DM: diabetes mellitus; ETOH: ethanol; IL: interleukin; LPS: lipopolysaccharide; NAFLD: non-alcoholic fatty liver disease; NASH: non-alcoholic steatohepatitis; PPI: proton pump inhibitor; SIBO: small intestinal bacterial overgrowth; TLR-4: toll-like receptor 4; TMAO: trimethylamine-N-oxide (TMAO); TNF-α: tumor necrosis factor alpha.

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