Small intestinal bacterial overgrowth in patients suffering from scleroderma: Clinical effectiveness of its eradication

Andrea Parodi, Marta Sessarego, Alfredo Greco, Marco Bazzica, Gilberto Filaci, Maurizio Setti, Edoardo Savarino, Francesco Indiveri, Vincenzo Savarino, Massimo Ghio

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: After the skin, the gastrointestinal tract is the second most common target of systemic sclerosis (SSc). AIM: Our aims were to investigate orocecal transit time (OCTT) and the presence of small intestinal bacterial overgrowth (SIBO) in SSc as a cause of intestinal symptoms. METHODS: Fifty-five SSc patients and 60 healthy controls, sex and age matched, entered the study. Enrolled subjects completed a questionnaire for intestinal symptoms and a global symptomatic score (GSS) was calculated. OCTT and the presence of SIBO were assessed by a lactulose breath test (LBT). Patients with SIBO were treated with rifaximin 1,200 mg/day for 10 days. Finally, a second questionnaire and LBT were performed 1 month after the end of therapy. RESULTS: The prevalence of SIBO was higher in SSc patients compared with controls (30/54 vs 4/60, respectively, P <0.001). OCTT was significantly slower in SSc patients compared with controls (150 min, 25-75th percentile 142.5-165 vs 105 min, 25-75th percentile 90-135, respectively, P <0.001). In patients with SIBO, the median GSS score was 8 (25-75th percentile 3.25-10.75). Eradication of SIBO was achieved in 73.3% of patients, with a significant reduction of symptoms in 72.7% of them (GSS score 2, 25-75th percentile 1-3, P <0.05). CONCLUSIONS: These data suggest that SIBO occurs more frequently in SSc patients than in controls. Intestinal symptoms in these patients may be related to this syndrome and its eradication seems useful to improve clinical features. OCTT is significantly delayed in SSc patients, suggesting an impairment of intestinal motility, a further risk factor for the development of SIBO.

Original languageEnglish
Pages (from-to)1257-1262
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume103
Issue number5
DOIs
Publication statusPublished - May 2008

ASJC Scopus subject areas

  • Gastroenterology

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    Parodi, A., Sessarego, M., Greco, A., Bazzica, M., Filaci, G., Setti, M., Savarino, E., Indiveri, F., Savarino, V., & Ghio, M. (2008). Small intestinal bacterial overgrowth in patients suffering from scleroderma: Clinical effectiveness of its eradication. American Journal of Gastroenterology, 103(5), 1257-1262. https://doi.org/10.1111/j.1572-0241.2007.01758.x