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Discussion Starter · #1 ·
Found this while wandering on MedlineTitle Does long-term inhibition of gastric acid secretion with omeprazole lead to small intestinal bacterial overgrowth? Author Nelis GF ; Engelage AH ; Samson G Address Department of Gastroenterology, Sophia Hospital, Zwolle, Netherlands. Source Neth J Med, 45(3):93-100 1994 Sep Abstract OBJECTIVE: Gastric acid secretion and small intestinal motility are the main mechanisms of defense against bacterial overgrowth of the proximal digestive tract. Bacterial colonization of the stomach during gastric acid inhibition has been documented, but is probably without clinical consequence. However, small intestinal bacterial overgrowth can have serious clinical implications with malabsorption and diarrhoea. METHODS: We prospectively investigated small intestinal bacterial overgrowth in 40 patients receiving long-term omeprazole treatment using the [14C]glycocholic breath test. Tests were performed before omeprazole treatment, after 6 weeks treatment with 40 mg o.m. and after 26 weeks treatment with 20 mg; in the test each patient served as his own control. RESULTS: Breath tests, using individual curves, peak values, time at which the peak appeared and the area under the curve, did not differ significantly during treatment from those before treatment. CONCLUSIONS: We conclude that long-term strong inhibition of gastric acid secretion does not lead to small intestinal bacterial overgrowth. ------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 

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Are you referring to me by any chance. I remember finding something connecting the twoWhat does this study mean? Reduced gastric acidity does not cause bacterial overfgrowth or the reduced gastric acidity of the kind created by omeprazole over 26 weeks does not cause BO or are they one and the same?
 

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Discussion Starter · #3 ·
Coulda been you.There seems to be some hypothesis out there that if you reduce the stomach acidity with drugs you risk getting bacterial overgrowth in the small intestine, And since Stomach acid kills alot of bacteria it may not be a far fetched idea, but is one I hadn't seen (or really looked for) much data to back it up. There tend to be alot of things like that conventional wisdom says one thing but you never really know until you test it.At least with this drug in a fairly long term study there was no increased risk of BO from the drastic reduction of stomach acidity. I don't have any reason to believe that one drug would be different that other drugs, reduced acidity should be reduced acidity. K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html [This message has been edited by kmottus (edited 04-18-2001).]
 

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Ok I had found something which said reduced gastric acidity causes BO but not that drugs like omeprazole cause BO. An interesting study though I must say though that 26 weeks does not seem to be a long time compared to, say , a life time of reduced acidity. [This message has been edited by bonniei (edited 04-18-2001).]
 

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I would like to add in support of k's study for those who are interested in acid reducing drugs causing BO, I have been on Prilosec for 5 years and I recently had a BO test(glucose hydrogen breath test) done and I tested negative for it
 

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Discussion Starter · #8 ·
A number of sugars are used for this test. Lactulose seems to be the least specific and often has false positives.K.Title The lactulose breath hydrogen test and small intestinal bacterial overgrowth. Author Riordan SM ; McIver CJ ; Walker BM ; Duncombe VM ; Bolin TD ; Thomas MC Address Department of Gastroenterology, Prince of Wales Hospital, Sydney, Australia. Source Am J Gastroenterol, 91(9):1795-803 1996 Sep Abstract OBJECTIVES: To i) document the sensitivity and specificity of a combined scintigraphic/lactulose breath hydrogen test for small intestinal bacterial overgrowth and ii) investigate the validity of currently accepted definitions of an abnormal lactulose breath hydrogen test based on "double peaks" in breath hydrogen concentrations. METHODS: Twenty-eight subjects were investigated with culture of proximal small intestinal aspirate and a 10-g lactulose breath hydrogen test combined with scintigraphy. Gastroduodenal pH, the presence or absence of gastric bacterial overgrowth, and the in vitro capability of overgrowth flora to ferment lactulose were determined. RESULTS: Sensitivity (16.7%) and specificity (70.0%) of the lactulose breath hydrogen test alone for small intestinal bacterial overgrowth were poor. Combination with scintigraphy resulted in 100% specificity, because double peaks in serial breath hydrogen concentrations may occur as a result of lactulose fermentation by cecal bacteria. Sensitivity increased to 38.9% with scintigraphy, because a single rise in breath hydrogen concentrations, commencing before the test meal reaches the cecum, may occur in this disorder. Sensitivity remained suboptimal irrespective of the definition of small intestinal bacterial overgrowth used, the nature of the overgrowth flora, favorable luminal pH, the presence of concurrent gastric bacterial overgrowth, or the in vitro ability of the overgrowth flora to ferment lactulose. CONCLUSIONS: Definitions of an abnormal lactulose breath hydrogen test based on the occurrence of double peaks in breath hydrogen concentrations are inappropriate. Not even the addition of scintigraphy renders this test a clinically useful alternative to culture of aspirate for diagnosing small intestinal bacterial overgrowth.itle The diagnosis of small bowel bacterial overgrowth. Reliability of jejunal culture and inadequacy of breath hydrogen testing [see comments] Author Corazza GR ; Menozzi MG ; Strocchi A ; Rasciti L ; Vaira D ; Lecchini R ; Avanzini P ; Chezzi C ; Gasbarrini G Address I Department of Medical Pathology, S. Orsola University Hospital, University of Bologna, Italy. Source Gastroenterology, 98(2):302-9 1990 Feb Abstract The reliability of a single jejunal culture in the diagnosis of small bowel bacterial overgrowth has recently been questioned. Seventy-seven patients thought to have bacterial overgrowth, defined as a jejunal culture yielding at least 10(6) organisms per milliliter of aspirate, took part in the study. Bacterial overgrowth was found in 74% of the patients with predisposing conditions and in 32% of those with no clear causes of bacterial colonization. The intestinal juice of some patients was taken at two different levels of the proximal jejunum, using both the closed- and open-tube systems. Highly significant correlations (rs = 0.90, p less than 0.001) were found between the numbers of bacteria per milliliter at the 2 jejunal levels and between the numbers of bacteria per milliliter of jejunal aspirate obtained from the closed and open tubes (rs = 0.84, p less than 0.001). Compared with the jejunal culture, the gas chromatography of volatile fatty acids in jejunal aspirate and the glucose- and lactulose-hydrogen breath tests showed sensitivities of 56%, 62%, and 68% and specificities of 100%, 83%, and 44%, respectively. This work demonstrates the reliability of jejunal cultures and the inadequacy of breath hydrogen testing in the prediction of positive jejunal cultures. When results of testing for volatile fatty acids in jejunal aspirates are positive, this always indicates the presence of bacterial overgrowth; thus, this procedure would avoid the more complicated, time-consuming, and costly bacteriological analysis of jejunal samples------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 

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Discussion Starter · #11 ·
LOLI went through the school system during the NEW Math craze. Lots of Boolean logic problems and Venn (sp?) diagrams. Didn't help me learn to add any better but it sure comes in handy doing computer based literature searches.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 
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