Small intestinal bacterial overgrowth in inactive Crohn's disease: influence of thiopurine and biological treatment.
2014
AIM: To investigate the influence of thiopurines and biological drugs on the presence of small intestinal bacterial overgrowth (SIBO) in patients with inactive Crohn’s disease (CD).
METHODS: This was a prospective study in patients with CD in remission and without corticosteroid treatment, included consecutively from 2004 to 2010. SIBO was investigated using the hydrogen glucose breath test.
RESULTS: One hundred and seven patients with CD in remission were included. Almost 58% of patients used maintenance immunosuppressant therapy and 19.6% used biological therapy. The prevalence of SIBO was 16.8%. No association was observed between SIBO and the use of thiopurine Immunosuppressant (12/62 patients), administration of biological drugs (2/21 patients), or with double treatment with an anti-tumor necrosis factor drugs plus thiopurine (1/13 patients). Half of the patients had symptoms that were suggestive of SIBO, though meteorism was the only symptom that was significantly associated with the presence of SIBO on univariate analysis (P < 0.05). Multivariate analysis revealed that the presence of meteorism and a fistulizing pattern were associated with the presence of SIBO (P < 0.05).
CONCLUSION: Immunosuppressants and/or biological drugs do not induce SIBO in inactive CD. Fistulizing disease pattern and meteorism are associated with SIBO.
Keywords:
- Gastroenterology
- Thiopurine methyltransferase
- Prospective cohort study
- Corticosteroid
- Breath test
- General surgery
- Small intestinal bacterial overgrowth
- Immunology
- Crohn's disease
- Gastrointestinal agent
- Internal medicine
- Medicine
- Univariate analysis
- Bacterial overgrowth
- Disease
- Diabetes mellitus
- Inflammatory bowel disease
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