Related Experiment Video
Updated: Apr 22, 2026
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Small intestinal bacterial overgrowth in patients with chronic pancreatitis
Marianna Signoretti1, Serena Stigliano, Roberto Valente
1Digestive and Liver Disease Unit, S. Andrea Hospital, University "Sapienza," Rome, Italy.
Goals:
To assess the prevalence of small intestinal bacterial overgrowth (SIBO) in chronic pancreatitis (CP), and analyze factors related with SIBO in CP.
Background:
SIBO is to be considered a factor that worsens symptoms and nutritional status in patients with CP. However, the few studies evaluating the rate of SIBO in CP patients used nonuniform and nonstandardized procedures, and reported a wide range of positivity (0% to 92%). Those studies often investigated CP patients with previous resection surgery (cause of SIBO per se).
Study:
CP patients and controls evaluated for SIBO by the H2 glucose breath test with a standard protocol. For CP patients, the relationship between test results, abdominal symptoms, and clinical and biochemical variables was analyzed.
Results:
A total of 43 CP patients and 43 controls were enrolled. Of the CP patients, 8 had advanced disease (defined by M-ANNHEIM index) and none had undergone previous surgery. The glucose breath test positivity rate was higher in the CP patients than in the controls (21% vs. 14%), albeit without a significant difference (P=0.57). Mean fasting H2 excretion and mean H2 excretion at 120 minutes also had a trend toward higher levels in CP patients. There were no clinical differences between CP patients with or without SIBO, but there were nutritional differences for lower levels of vitamin D and higher levels of folate in these patients with SIBO.
Conclusions:
Our findings suggest that SIBO is not uncommon in uncomplicated CP patients. The lack of a significant difference compared with controls might be due to the study being underpowered. SIBO in CP patients does not seem to be related to peculiar clinical features, but it might affect nutritional status.
Insights
Small intestinal bacterial overgrowth (SIBO) is common in chronic pancreatitis (CP) patients, potentially impacting nutritional status. Further research is needed to confirm SIBO prevalence and its clinical significance in CP.
Area of Science:
- Gastroenterology
- Microbiology
- Nutritional Science
Background:
- Small intestinal bacterial overgrowth (SIBO) is implicated in worsening symptoms and nutritional status in chronic pancreatitis (CP).
- Previous studies on SIBO prevalence in CP lack standardization and often include post-surgical patients, confounding results.
- A wide range of SIBO positivity (0%–92%) has been reported in CP, necessitating standardized assessment.
Purpose of the Study:
- To determine the prevalence of SIBO in patients with chronic pancreatitis (CP).
- To identify factors associated with SIBO in CP patients.
- To analyze the relationship between SIBO, clinical symptoms, and nutritional status in CP.
Main Methods:
- A standardized H2 glucose breath test was used to evaluate SIBO in 43 CP patients and 43 controls.
- Clinical, biochemical, and nutritional variables were assessed in CP patients.
- The M-ANNHEIM index was used to classify disease severity in CP patients, excluding those with prior surgery.
Main Results:
- The SIBO positivity rate was 21% in CP patients versus 14% in controls, a difference that did not reach statistical significance (P=0.57).
- CP patients showed a trend toward higher fasting H2 excretion and 120-minute H2 excretion compared to controls.
- CP patients with SIBO exhibited lower vitamin D and higher folate levels, indicating potential nutritional impact, but no distinct clinical features were observed.
Conclusions:
- SIBO appears to be relatively common in uncomplicated CP patients.
- The lack of significant difference in SIBO prevalence compared to controls may be due to insufficient statistical power.
- SIBO in CP is not linked to specific clinical characteristics but may influence the patients' nutritional status.
Related Concept Videos
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:25Chronic Pancreatitis I: Introduction
01:21Chronic Pancreatitis II: Pathophysiology
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:25Acute Pancreatitis I: Introduction
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include: