Excessive Bacterial Growth Syndrome and Exocrine Pancreatic Insufficiency in Chronic Pancreatitis
Bacterial overgrowth syndrome (BOS) is characterized by clinical symptoms similar to those of exocrine pancreatic insufficiency (EPI) in chronic pancreatitis (CP). This phenomenon complicates differential diagnosis, especially when BOS and CP combined with EPI. BOS can contribute to the development of malabsorption and impaired digestion. As a result, it occurs diarrhea, steatorrhea, the lack of fat-soluble vitamins, as well as bloating and weight loss can be noticed. Pancreatic enzyme deficiency, alcohol abuse, use of narcotic analgesics to relieve abdominal pain, and proton pump inhibitors (PPIS) that cause drug hypochlohydria are predictors of the weakening of the gastroduodenal antibacterial barrier, and therefore potential risk factors for the development of BOS in CP, especially complicated by EPI. The lack of standard protocols and unified diagnostic methods does not provide the complete picture of the incidence of BOS in CP, and the available data are contradictory and heterogeneous. However, the verification of BOS in CP and way to correct it requires further research. Standardization of research methods and interpretation of results will allow implementing more specific and targeted treatment