[Syndrome of bacterial overgrowth in patients with the reduced stomach acid secretion: some aspects of the diagnosis].

Abstract To study the frequency of occurrence of small intestinal bacterial overgrowth (SIBO) in GERD patients with reduced stomach acid secretion receiving long-term PPI treatment, and patients with chronic atrophic gastritis with reduced stomach acid secretion, using the hydrogen breath test (HBT) and studies of short-chain fatty acids (SCFA) in various biological substrates; compare the obtained results. There were 100 people surveyed: 1 group consisted of 40 patients with chronic atrophic gastritis (HG) with reduced stomach acid secretion; 2 group consisted of 60 patients of GERD in patients receiving PPI different duration (0-6 months, 6-12 months more than 12 months). All the patients were examined by a load of lactulose and research SCFA using gas-liquid chromatographic analysis (GC-analysis) in various biological substrates (duodenal secretion and feces). When performing HBT in patients with chronic atrophic gastritis frequency detection SIBO amounted to 57.5 per cent. In GERD patients receiving PPI SIBO was detected in 8.3% of cases (0-6 months of treatment), 21.7% (6-12 months of treatment), 61.6% (over 12 months). 15% of HG patients and 13.3% of GERD patients receiving PPI, with clinical manifestations of SIBO, the data turned out to be negative. The SCFA parameters in the duodenal secretion in patients with GERD during PPI therapy depending on the duration of the admission and in HG patients with reduced stomach acid secretion were studied, as well as in patients with clinical manifestations of SIBO depending on the data of HBT (+/-). We also studied SCFA parameters in patients with positive HBT results depending on time of registration of the increase of hydrogen concentration. It is established that the study of SCFA in the duodenal secretion is an important diagnostic SIBO test, which allows not only to detect increased activity of the microflora, but also to determine its tribal affiliation. In some cases, its information value exceeds the HBT. The study of SCFA in various biological substrates (duodenal secretion, feces) allows you to specify the localization of existing violations. The rapidity of obtaining results allows to consider this method as screening.