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This retrospective analysis investigated the intriguing interplay between small intestinal bacterial overgrowth (SIBO) and gastroesophageal reflux disease (GERD), with particular emphasis on the role of acid-suppressive therapy.
GERD shows a strong association with SIBO, particularly in patients with methane-positive breath tests. Bacteroides uniformis emerges as a key microbial marker, with metabolic changes linked to ATP-binding cassette transporters.
This retrospective analysis investigated the intriguing interplay between small intestinal bacterial overgrowth (SIBO) and gastroesophageal reflux disease (GERD), with particular emphasis on the role of acid-suppressive therapy. It also explored alterations in gut microbiota composition and metabolic profiles in individuals diagnosed with both ailments.
Volunteers completed clinical questionnaires and underwent hydrogen/methane breath testing and gastroscopy. GERD was diagnosed based on the GERD questionnaire (GERD-Q) scale and endoscopic findings. SIBO was confirmed via breath tests. The study scrutinized the link between SIBO and GERD, recognized SIBO risk factors, and monitored fecal microbiota utilizing 16S rRNA sequencing to better comprehend microbial and metabolic alterations.
A total of 394 patients were incorporated, with 148 diagnosed with GERD and 287 testing positive for SIBO. Among those with SIBO, 270 had positive methane (CH4) and 97 had positive hydrogen (H2) breath tests. The prevalence of GERD was quite higher among those with SIBO (P = 0.007), with a stronger link witnessed in CH4-positive individuals as opposed to H2-positive cases (P = 0.020).
Logistic regression analysis indicated GERD as a standalone risk factor for SIBO. Short-term, low-dose acid-suppressive medications had no significant effect on SIBO development. Microbiota analysis in 24 patients revealed that Bacteroides uniformis and Bacteroides stercoris were predominant in those with both GERD and SIBO. Metabolic profiling pointed to shifts involving ATP-binding cassette (ABC) transporters, hinting at a deeper biochemical link.
GERD was found to be extensively related to SIBO, particularly in those with positive CH4 breath tests. The microbial fingerprint of GERD-SIBO patients differed markedly from healthy profiles, with Bacteroides uniformis emerging as a potential hallmark species. Metabolic disruptions in these patients were primarily related to ABC transporter activity.
Journal of Inflammation Research
Correlation Between Gastroesophageal Reflux Disease and Small Intestinal Bacterial Overgrowth: Analysis of Intestinal Microbiome and Metabolic Characteristics
Zi-Teng Wang et al.
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