| BackgroundIntestinal bacterial overgrowth(SIBO)is known to be associated with several diseases intestinal diseases by more and more people.Previous studies have shown that Hypochlorhydria and Intestinal dysmotility are the pathogenesis of intestinal bacterial overgrowth.Proton pump inhibitors(PPIs)are stable,effective and long-lasting,Widely used in diseases related to stomach acid,but with the long-term application of PPIs,many patients have symptoms such as bloating,diarrhea,abdominal pain and constipation.This is similar to the SIBO symptoms,which inevitably links the application of PPIs to SIBO.At present,there are many studies on the relationship between PPIs and SIBO.Prokinetics can improve intestinal motility,enhance gastric and duodenal motility,and promote gastric emptying.they are often prescribed with proton pump inhibitors(PPIs)in patients with gastroesophageal reflux disease(GERD)and/or functional dyspepsia.However,there is no existing literature on the effects of long-term use of PPIs and gastrointestinal motility drugs on SIBO.This study is intended to investigate the effects of PPIs combined with gastrointestinal motility drugs on the risk of SIBO and the effect of oral-colon transit time(OCTT).ObjectiveThrough testing patients SIBO and OCTT through lactulose hydrogen breath test(LHBT),The purpose of this study was to assess the prevalence of intestinal bacterial overgrowth and the OCTT in patients taking PPIs compared with those taking PPIs plus prokinetics.MethodThis study is a single-center cross-sectional study.From February 2018 to October 2018,A total of 143 patients were selected,who were recruited from the outpatient clinic and inpatient patient,the first affiliated hospital of Zhengzhou University.The statistics were included in the general condition of the patient,including age,sex,body mass index,the type and timing of taking PPIs,the disease,and the practical use of gastrointestinal motility drugs.Enrolled patients were divided into two groups: patients taking PPIs for more than 2 months(Group A)and those taking PPIs with prokinetics for more than 2 months(Group B)for various indications.All patients underwent LHBT.Result1.there was no significant difference in the gender,age and Body mass index index between group A and group B(P > 0.05).The data of the two groups were comparable.2.About the SIBO positive rate,the SIBO positive rate of group A was 15.7%,while that of group B was 3.7%,and the difference between the two groups was statistically significant(P = 0.030).This indicated that the SIBO positive rate was significantly reduced in patients taking PPIs combined with gastrointestinal motility drugs compared with patients taking PPIs alone.3.In the term of OCTT,median OCTT was 128.4min in group A and 120.3min in group B,in the two groups,the difference was statistically significant(P = 0.018).In the group A,median OCTT of SIBO positive patients was 136.1min,while that of SIBO negative patients was 125.7min.The difference was statistically significant(P= 0.031).4.In the present study.The prevalence between specific proton pump inhibitors and SIBO was not statistically significant(P>0.05).Similarly,In the group A,the time of PPIs use in the SIBO-positive group and the SIBO-negative group was 6.4(5.8-7.0)months and 4.8(3.0-7.0)months.respectively,the differences between the groups were not statistically significant,P = 0.066.Conclusion1.SIBO positive patients are more prolonged than negative patients with OCTT.2.Gastrointestinal motility agents in combination with PPIs therapy can reduce the risk of SIBO by enhancing gastrointestinal motility and may reduce the risk of long-term use of PPIs. |
