The Impact of Alcohol Consumption and Cholecystectomy.pdf

ORIGINAL ARTICLE The Impact of Alcohol Consumption and Cholecystectomy on Small Intestinal Bacterial Overgrowth Scott L. Gabbard ? Brian E. Lacy ? Gary M. Levine ? Michael D. Crowell Received: 9 August 2013 / Accepted: 14 November 2013  Springer Science+Business Media New York 2013 Abstract Background The etiology of small intestinal bacterial overgrowth (SIBO) is diverse and frequently multi-facto- rial. SIBO is thought to result from structural changes of the gastrointestinal tract, disordered peristalsis of the stomach and/or small intestine, or a disruption of the nor- mal mucosal defenses of the small intestine. Alcoholics are reported to have higher rates of SIBO, as diagnosed by jejunal aspirate; however, no data are available on the association between moderate alcohol consumption and SIBO. Aim To evaluate the association between moderate alcohol consumption and SIBO and identify risk factors for SIBO using the lactulose breath test (LBT). Methods A retrospective chart review was completed for 210 consecutive patients who underwent the LBT between 2008 and 2010. We reviewed demographic data, including age, race, body mass index, alcohol and tobacco history, medication use, comorbid medical conditions, and history of abdominal surgery. Results The study included 196 patients (68 % female; mean age 55 years), 93 of whom had a positive LBT (47.4 %). Of those patients who consumed a moderate amount of alcohol, 58 % had a positive LBT, compared to 38.9 % of abstainers (P = 0.008). Those with a history of cholecystectomy had significantly lower rates of a positive LBT than those who had not (33.3 vs. 51.7 % respectively; P = 0.031). Neither proton pump inhibitor (PPI) use nor tobacco use was associated with a positive LBT. Conclusion In this retrospective review, moderate alco- hol consumption was a strong risk factor for SIBO. Cho- lecystectomy appeared to be protective against SIBO. Neither PPI use nor tobacco use was associated with an increased risk of SIBO.