scholarly journals The Role of Fecal Calprotectin in Patients with Systemic Sclerosis and Small Intestinal Bacterial Overgrowth (SIBO)

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 587
Author(s):  
Beata Polkowska-Pruszyńska ◽  
Agnieszka Gerkowicz ◽  
Karol Rawicz-Pruszyński ◽  
Dorota Krasowska
Keyword(s):  
Systemic Sclerosis ◽  
Gastrointestinal Symptoms ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Fecal Calprotectin ◽  
Hydrogen Breath Test ◽  
Noninvasive Test ◽  
Intestinal Bacterial Overgrowth ◽  
Small Intestinal

Fecal calprotectin (FC) is a quick, cost-effective, and noninvasive test, which is used to diagnose patients with active inflammatory bowel diseases (IBD). Recent studies suggest the possible predictive role of FC in the diagnosis of small intestinal bacterial overgrowth (SIBO) in patients with systemic sclerosis (SSc). This study aimed to assess the predictive value of FC in SSc patients and its’ possible use as a SIBO marker. A total of 40 SSc patients and 39 healthy volunteers were enrolled in the study. All subjects completed questionnaires evaluating gastrointestinal symptoms, FC measurements, and lactulose hydrogen breath test (LHBT) assessing SIBO presence. After rifaximin treatment, patients with SIBO underwent the same diagnostic procedures. Significantly higher FC values were observed in the study group compared to controls (97 vs. 20 μg/g; p < 0.0001) and in SSc patients diagnosed with SIBO compared to SSc patients without SIBO (206 vs. 24 μg/g; p = 0.0010). FC turned out to be a sensitive (94.12%) and specific (73.68%) marker in the detection of SIBO in patients with SSc (AUC = 0.82, 95% CI = 0.66–0.93; p < 0.0001). Our study suggests the potential value of FC in SSc in detecting gastrointestinal impairment and its promising role as an additional diagnostic tool for SIBO.

Small intestinal bacterial overgrowth in systemic sclerosis

2019 ◽  
Vol 5 (1) ◽  
pp. 33-39
Author(s):  
Kathleen Morrisroe ◽  
Murray Baron ◽  
Tracy Frech ◽  
Mandana Nikpour
Keyword(s):  
Systemic Sclerosis ◽  
Gastrointestinal Tract ◽  
Clinical Symptoms ◽  
Bacterial Overgrowth ◽  
Intestinal Bacteria ◽  
Small Intestinal Bacterial Overgrowth ◽  
Therapeutic Trial ◽  
Hydrogen Breath Test ◽  
Intestinal Bacterial Overgrowth ◽  
Small Intestinal

Systemic sclerosis is a multi-organ autoimmune disease characterized by vasculopathy and fibrosis, and it is arguably the most devastating of the rheumatological diseases. The gastrointestinal tract is the most commonly involved internal organ in systemic sclerosis. Gastrointestinal tract involvement is reported in up to 90% of SSc patients, is the leading cause of morbidity, and is the third most common cause of mortality in this disease. Among all gastrointestinal tract manifestations, small intestinal bacterial overgrowth is one manifestation that may be ameliorated and even eradicated with appropriate treatment, if recognized early. Small intestinal bacterial overgrowth occurs with a prevalence of approximately 39% in systemic sclerosis and presents with a range of non-specific gastrointestinal tract symptoms, including diarrhea, flatulence, abdominal pain, bloating, and early satiety. These manifestations occur due to an alteration and overgrowth of small intestinal bacteria occurring in the setting of gastrointestinal tract dysmotility and slow transit time. The clinical diagnosis of small intestinal bacterial overgrowth is commonly based on the presence of characteristic clinical symptoms together with a positive hydrogen breath test and response to a therapeutic trial of oral antibiotics used sequentially. Almost two-thirds of systemic sclerosis patients with small intestinal bacterial overgrowth have an improvement in their gastrointestinal tract symptoms with rotating antibiotics. Untreated small intestinal bacterial overgrowth can lead to malnutrition, and thus an important aspect of treatment is the identification and treatment of any associated vitamin and mineral deficiencies. This article focuses on small intestinal bacterial overgrowth, an important and understudied area in systemic sclerosis that remains a diagnostic and therapeutic challenge for both patients and clinicians alike.

scholarly journals Small intestinal bacterial overgrowth in systemic sclerosis: a review of the literature

2018 ◽  
Vol 311 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Beata Polkowska-Pruszyńska ◽  
Agnieszka Gerkowicz ◽  
Paulina Szczepanik-Kułak ◽  
Dorota Krasowska
Keyword(s):  
Systemic Sclerosis ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Review Of The Literature ◽  
Intestinal Bacterial Overgrowth ◽  
Small Intestinal

Small Intestinal Bacterial Overgrowth: Histopathologic Features and Clinical Correlates in an Underrecognized Entity

2010 ◽  
Vol 134 (2) ◽  
pp. 264-270 ◽  
Author(s):  
Paul J. Lappinga ◽  
Susan C. Abraham ◽  
Joseph A. Murray ◽  
Emily A. Vetter ◽  
Robin Patel ◽  
...  
Keyword(s):  
Clinical Features ◽  
Reference Range ◽  
Gastrointestinal Symptoms ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Presenting Symptoms ◽  
Intestinal Bacterial Overgrowth ◽  
Colony Forming Units ◽  
Small Intestinal ◽  
Duodenal Biopsies

Abstract Context Small intestinal bacterial overgrowth (SIBO) is a common cause of chronic diarrhea and malabsorption. Morphologic changes associated with this condition have not, to our knowledge, been studied in detail. Objective To better characterize the histopathologic changes associated with SIBO by comparing the clinicopathologic features of patients with SIBO (duodenal aspirate cultures with ≥105 colony-forming units [CFUs]/mL) to controls with cultures found to be negative (&lt;105 CFUs/mL). Design We included 67 consecutive patients with SIBO and 55 controls in the series. Each duodenal biopsy was assessed for the following features: villous to crypt ratio, intraepithelial lymphocytosis, crypt apoptoses, basal plasmacytosis, cryptitis/villitis, peptic duodenitis, erosions/ulcers, eosinophilia, and absence of goblet and Paneth cells; and correlated with clinical features and culture results. Results Decreased villous to crypt ratio (&lt;3∶1) was more frequent in SIBO than controls (24% versus 7%; P  =  .01). Duodenal biopsies from patients with SIBO were slightly less likely to be judged within reference range than were controls (52% versus 64%; P  =  .27). There were no significant differences in any of the other histologic features. Clinically, patients in the SIBO group were older than the age of controls (mean, 60 years versus 52 years; P  =  .02), and they were more likely to have one of the known predisposing factors for bacterial overgrowth (66% versus 36%; P  =  .002). Other clinical features, including presenting symptoms, were similar. Conclusions Villous blunting is the only feature more common to SIBO than to controls. More than half of biopsies from SIBO patients are histologically unremarkable. Therefore, SIBO needs to be considered as a potential etiology for gastrointestinal symptoms even when duodenal biopsies are found to be normal.

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