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Maurizio Gabrielli - One of the best experts on this subject based on the ideXlab platform.
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The role of small intestinal Bacterial Overgrowth in Parkinson's disease
Movement disorders : official journal of the Movement Disorder Society, 2013Co-Authors: Alfonso Fasano, Maurizio Gabrielli, Francesco Bove, Martina Petracca, Maria Assunta Zocco, Enzo Ragazzoni, Federico Barbaro, Carla Piano, Serena Fortuna, Annalisa TortoraAbstract:Parkinson's disease is associated with gastrointestinal motility abnormalities favoring the occurrence of local infections. The aim of this study was to investigate whether small intestinal Bacterial Overgrowth contributes to the pathophysiology of motor fluctuations. Thirty-three patients and 30 controls underwent glucose, lactulose, and urea breath tests to detect small intestinal Bacterial Overgrowth and Helicobacter pylori infection. Patients also underwent ultrasonography to evaluate gastric emptying. The clinical status and plasma concentration of levodopa were assessed after an acute drug challenge with a standard dose of levodopa, and motor complications were assessed by Unified Parkinson's Disease Rating Scale-IV and by 1-week diaries of motor conditions. Patients with small intestinal Bacterial Overgrowth were treated with rifaximin and were clinically and instrumentally reevaluated 1 and 6 months later. The prevalence of small intestinal Bacterial Overgrowth was significantly higher in patients than in controls (54.5% vs. 20.0%; P = .01), whereas the prevalence of Helicobacter pylori infection was not (33.3% vs. 26.7%). Compared with patients without any infection, the prevalence of unpredictable fluctuations was significantly higher in patients with both infections (8.3% vs. 87.5%; P = .008). Gastric half-emptying time was significantly longer in patients than in healthy controls but did not differ in patients based on their infective status. Compared with patients without isolated small intestinal Bacterial Overgrowth, patients with isolated small intestinal Bacterial Overgrowth had longer off time daily and more episodes of delayed-on and no-on. The eradication of small intestinal Bacterial Overgrowth resulted in improvement in motor fluctuations without affecting the pharmacokinetics of levodopa. The relapse rate of small intestinal Bacterial Overgrowth at 6 months was 43%. © 2013 Movement Disorder Society.
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Prevalence of Small Intestinal Bacterial Overgrowth in Parkinson's Disease†
Movement disorders : official journal of the Movement Disorder Society, 2011Co-Authors: Maurizio Gabrielli, Ernesto Cristiano Lauritano, Emidio Scarpellini, Patrizia Bonazzi, E. Bendia, Alfonso Fasano, Maria Gabriella Ceravolo, Marianna Capecci, Anna Rita Bentivoglio, Leandro ProvincialiAbstract:Background: Parkinson's disease (PD) is associated with gastrointestinal motility abnormalities that could favor the occurrence of small intestinal Bacterial Overgrowth. The aim of the study was to assess the prevalence of small intestinal Bacterial Overgrowth in PD patients. Methods: Consecutive PD patients were enrolled. The controls were subjects without PD. All patients and controls underwent the glucose breath test to assess small intestinal Bacterial Overgrowth. Results: Forty-eight PD patients and 36 controls were enrolled. The prevalence of small intestinal Bacterial Overgrowth was significantly higher in PD patients than in controls (54.17% vs 8.33%; P < .0001; OR, 2.24; 95% CI, 3.50–48.24). Multivariate analysis showed Hoehn and Yahr stage (OR, 3.07; 95% CI, 1.14–8.27) and Unified PD Rating score (OR, 1.12; 95% CI, 1.02–1.23) were significantly associated with small intestinal Bacterial Overgrowth in PD patients. Conclusions: Small intestinal Bacterial Overgrowth is highly prevalent in PD. Gastrointestinal motility abnormalities might explain this association. © 2011 Movement Disorder Society
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Treatment options for small intestinal Bacterial Overgrowth
Digestive and Liver Disease Supplements, 2009Co-Authors: Maurizio Gabrielli, Ernesto Cristiano Lauritano, L. Sparano, Davide Roccarina, Giovanna Vitale, Antonio GasbarriniAbstract:Abstract The best therapeutic approach for patients with small bowel Bacterial Overgrowth is a combination of the removal of all predisposing conditions and the administration of broad-spectrum antibiotics. In the case of non-modifiable predisposing factors, patients with Bacterial Overgrowth need a strict follow-up after successful decontamination with antibiotics, in order to promptly assess and treat disease recurrence. Up to now, the choice of antibiotics has been primarily empiric because of the presence of several different Bacterial species in the contaminating flora and the impossibility of applying in vitro susceptibility tests. Several systemic and non-absorbable antibiotic agents have been shown to be effective for decontamination of small bowel Bacterial Overgrowth. The best antibiotic scheme in terms of drug, dosage and duration of therapy remains, however, to be assessed. The non-absorbable agents seem to be associated with better safety and tolerability than systemic drugs. In the present paper, all available therapeutic approaches to small bowel Bacterial Overgrowth are reviewed.
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Antibiotic therapy in small intestinal Bacterial Overgrowth: rifaximin versus metronidazole
European review for medical and pharmacological sciences, 2009Co-Authors: Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Veronica Ojetti, Davide Roccarina, Alessia Villita, E Fiore, Roberto Flore, Angelo Santoliquido, Paolo TondiAbstract:Background and objectives Few controlled trials on antibiotic therapy for small intestinal Bacterial Overgrowth are available at present. Aim of the study was to assess efficacy, safety and tolerability of rifaximin with respect to metronidazole for the treatment of small intestinal Bacterial Overgrowth. Material and methods We enrolled 142 consecutive patients with diagnosis of small intestinal Bacterial Overgrowth. Diagnosis of small intestinal Bacterial Overgrowth based on the clinical history and the positivity of glucose breath test. Patients were randomised to two 7-day treatment groups: rifaximin 1200 mg/day and metronidazole 750 mg/day. Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated. Results One drop-out was observed in rifaximin group. Five drops-out occurred in metronidazole group. The glucose breath test normalization rate was significantly higher in the rifaximin with respect to the metronidazole group (63.4% versus 43.7%; p Discussion Rifaximin showed an higher SIBO decontamination rate than metronidazole at the tested doses, both with a significant gain in terms of tolerability. Either the present study or recent evidencies suggest that rifaximin represents a good choice for the management of patients affected by SIBO.
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Small intestinal Bacterial Overgrowth: diagnosis and treatment.
Digestive Diseases, 2007Co-Authors: Antonio Gasbarrini, Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Veronica Ojetti, Giovanni GasbarriniAbstract:Small intestinal Bacterial Overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine. The main mechanisms restricting Bacterial colonization in the upper gut are the gastric acid barrier, mucosal and systemic immunity and intestinal clearance. When these mechanisms fail, Bacterial Overgrowth develops. Diarrhea, steatorrhea, chronic abdominal pain, bloating and flatulence are common symptoms and are similar to those observed in irritable bowel syndrome. Breath tests (glucose and/or lactulose breath tests) have been proposed as a sensitive and simple tool for the diagnosis of Bacterial Overgrowth, being non-invasive and inexpensive compared to the gold standard represented by the culture of intestinal aspirates. Antibiotic therapy is the cornerstone of SIBO treatment. Current SIBO treatment is based on empirical courses of broad-spectrum antibiotics since few controlled studies concerning the choice and duration of antibiotic therapy are available at present.
Ernesto Cristiano Lauritano - One of the best experts on this subject based on the ideXlab platform.
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Prevalence of Small Intestinal Bacterial Overgrowth in Parkinson's Disease†
Movement disorders : official journal of the Movement Disorder Society, 2011Co-Authors: Maurizio Gabrielli, Ernesto Cristiano Lauritano, Emidio Scarpellini, Patrizia Bonazzi, E. Bendia, Alfonso Fasano, Maria Gabriella Ceravolo, Marianna Capecci, Anna Rita Bentivoglio, Leandro ProvincialiAbstract:Background: Parkinson's disease (PD) is associated with gastrointestinal motility abnormalities that could favor the occurrence of small intestinal Bacterial Overgrowth. The aim of the study was to assess the prevalence of small intestinal Bacterial Overgrowth in PD patients. Methods: Consecutive PD patients were enrolled. The controls were subjects without PD. All patients and controls underwent the glucose breath test to assess small intestinal Bacterial Overgrowth. Results: Forty-eight PD patients and 36 controls were enrolled. The prevalence of small intestinal Bacterial Overgrowth was significantly higher in PD patients than in controls (54.17% vs 8.33%; P < .0001; OR, 2.24; 95% CI, 3.50–48.24). Multivariate analysis showed Hoehn and Yahr stage (OR, 3.07; 95% CI, 1.14–8.27) and Unified PD Rating score (OR, 1.12; 95% CI, 1.02–1.23) were significantly associated with small intestinal Bacterial Overgrowth in PD patients. Conclusions: Small intestinal Bacterial Overgrowth is highly prevalent in PD. Gastrointestinal motility abnormalities might explain this association. © 2011 Movement Disorder Society
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Treatment options for small intestinal Bacterial Overgrowth
Digestive and Liver Disease Supplements, 2009Co-Authors: Maurizio Gabrielli, Ernesto Cristiano Lauritano, L. Sparano, Davide Roccarina, Giovanna Vitale, Antonio GasbarriniAbstract:Abstract The best therapeutic approach for patients with small bowel Bacterial Overgrowth is a combination of the removal of all predisposing conditions and the administration of broad-spectrum antibiotics. In the case of non-modifiable predisposing factors, patients with Bacterial Overgrowth need a strict follow-up after successful decontamination with antibiotics, in order to promptly assess and treat disease recurrence. Up to now, the choice of antibiotics has been primarily empiric because of the presence of several different Bacterial species in the contaminating flora and the impossibility of applying in vitro susceptibility tests. Several systemic and non-absorbable antibiotic agents have been shown to be effective for decontamination of small bowel Bacterial Overgrowth. The best antibiotic scheme in terms of drug, dosage and duration of therapy remains, however, to be assessed. The non-absorbable agents seem to be associated with better safety and tolerability than systemic drugs. In the present paper, all available therapeutic approaches to small bowel Bacterial Overgrowth are reviewed.
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Antibiotic therapy in small intestinal Bacterial Overgrowth: rifaximin versus metronidazole
European review for medical and pharmacological sciences, 2009Co-Authors: Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Veronica Ojetti, Davide Roccarina, Alessia Villita, E Fiore, Roberto Flore, Angelo Santoliquido, Paolo TondiAbstract:Background and objectives Few controlled trials on antibiotic therapy for small intestinal Bacterial Overgrowth are available at present. Aim of the study was to assess efficacy, safety and tolerability of rifaximin with respect to metronidazole for the treatment of small intestinal Bacterial Overgrowth. Material and methods We enrolled 142 consecutive patients with diagnosis of small intestinal Bacterial Overgrowth. Diagnosis of small intestinal Bacterial Overgrowth based on the clinical history and the positivity of glucose breath test. Patients were randomised to two 7-day treatment groups: rifaximin 1200 mg/day and metronidazole 750 mg/day. Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated. Results One drop-out was observed in rifaximin group. Five drops-out occurred in metronidazole group. The glucose breath test normalization rate was significantly higher in the rifaximin with respect to the metronidazole group (63.4% versus 43.7%; p Discussion Rifaximin showed an higher SIBO decontamination rate than metronidazole at the tested doses, both with a significant gain in terms of tolerability. Either the present study or recent evidencies suggest that rifaximin represents a good choice for the management of patients affected by SIBO.
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Small intestinal Bacterial Overgrowth: diagnosis and treatment.
Digestive Diseases, 2007Co-Authors: Antonio Gasbarrini, Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Veronica Ojetti, Giovanni GasbarriniAbstract:Small intestinal Bacterial Overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine. The main mechanisms restricting Bacterial colonization in the upper gut are the gastric acid barrier, mucosal and systemic immunity and intestinal clearance. When these mechanisms fail, Bacterial Overgrowth develops. Diarrhea, steatorrhea, chronic abdominal pain, bloating and flatulence are common symptoms and are similar to those observed in irritable bowel syndrome. Breath tests (glucose and/or lactulose breath tests) have been proposed as a sensitive and simple tool for the diagnosis of Bacterial Overgrowth, being non-invasive and inexpensive compared to the gold standard represented by the culture of intestinal aspirates. Antibiotic therapy is the cornerstone of SIBO treatment. Current SIBO treatment is based on empirical courses of broad-spectrum antibiotics since few controlled studies concerning the choice and duration of antibiotic therapy are available at present.
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Association between hypothyroidism and small intestinal Bacterial Overgrowth.
The Journal of clinical endocrinology and metabolism, 2007Co-Authors: Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Anna Lisa Bilotta, Antonio Laginestra, Marialuisa Novi, S. Sottili, Michele Serricchio, Giovanni CammarotaAbstract:Objectives: Small intestinal Bacterial Overgrowth is defined as an abnormally high Bacterial population level in the small intestine. Intestinal motor dysfunction associated with hypothyroidism could predispose to Bacterial Overgrowth. Luminal bacteria could modulate gastrointestinal symptoms and interfere with levothyroxine absorption. The aims of the present study were to assess the prevalence and clinical pattern of Bacterial Overgrowth in patients with a history of overt hypothyroidism and the effects of Bacterial Overgrowth decontamination on thyroid hormone levels. Methods: A total of 50 consecutive patients with a history of overt hypothyroidism due to autoimmune thyroiditis was enrolled. Diagnosis of Bacterial Overgrowth was based on positivity to a hydrogen glucose breath test. Bacterial Overgrowth positive patients were treated with 1200 mg rifaximin each day for a week. A glucose breath test, gastrointestinal symptoms, and thyroid hormone plasma levels were reassessed 1 month after treatment. R...
Andrea Lupascu - One of the best experts on this subject based on the ideXlab platform.
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Small intestinal Bacterial Overgrowth: diagnosis and treatment.
Digestive Diseases, 2007Co-Authors: Antonio Gasbarrini, Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Veronica Ojetti, Giovanni GasbarriniAbstract:Small intestinal Bacterial Overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine. The main mechanisms restricting Bacterial colonization in the upper gut are the gastric acid barrier, mucosal and systemic immunity and intestinal clearance. When these mechanisms fail, Bacterial Overgrowth develops. Diarrhea, steatorrhea, chronic abdominal pain, bloating and flatulence are common symptoms and are similar to those observed in irritable bowel syndrome. Breath tests (glucose and/or lactulose breath tests) have been proposed as a sensitive and simple tool for the diagnosis of Bacterial Overgrowth, being non-invasive and inexpensive compared to the gold standard represented by the culture of intestinal aspirates. Antibiotic therapy is the cornerstone of SIBO treatment. Current SIBO treatment is based on empirical courses of broad-spectrum antibiotics since few controlled studies concerning the choice and duration of antibiotic therapy are available at present.
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Association between hypothyroidism and small intestinal Bacterial Overgrowth.
The Journal of clinical endocrinology and metabolism, 2007Co-Authors: Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Anna Lisa Bilotta, Antonio Laginestra, Marialuisa Novi, S. Sottili, Michele Serricchio, Giovanni CammarotaAbstract:Objectives: Small intestinal Bacterial Overgrowth is defined as an abnormally high Bacterial population level in the small intestine. Intestinal motor dysfunction associated with hypothyroidism could predispose to Bacterial Overgrowth. Luminal bacteria could modulate gastrointestinal symptoms and interfere with levothyroxine absorption. The aims of the present study were to assess the prevalence and clinical pattern of Bacterial Overgrowth in patients with a history of overt hypothyroidism and the effects of Bacterial Overgrowth decontamination on thyroid hormone levels. Methods: A total of 50 consecutive patients with a history of overt hypothyroidism due to autoimmune thyroiditis was enrolled. Diagnosis of Bacterial Overgrowth was based on positivity to a hydrogen glucose breath test. Bacterial Overgrowth positive patients were treated with 1200 mg rifaximin each day for a week. A glucose breath test, gastrointestinal symptoms, and thyroid hormone plasma levels were reassessed 1 month after treatment. R...
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high dosage rifaximin for the treatment of small intestinal Bacterial Overgrowth
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Emidio Scarpellini, Maurizio Gabrielli, Andrea Lupascu, Giovanni Gasbarrini, Giovanni Cammarota, C Lauritano, Giuseppe Merra, I A Cazzato, Antonio GasbarriniAbstract:ummary Background Rifaximin is a broad spectrum non-absorbable antibiotic used for treatment of small intestinal Bacterial Overgrowth. Doses of 1200 mg/day showed a decontamination rate of 60% with low side-effects incidence. Aims To assess efficacy, safety and tolerability of rifaximin 1600 mg with respect to 1200 mg/day for small intestinal Bacterial Overgrowth treatment. Methods Eighty consecutive small intestinal Bacterial Overgrowth patients were enrolled. Diagnosis of small intestinal Bacterial Overgrowth based the clinical history and positivity to H2/CH4 glucose breath test. Patients were randomized in two 7-day treatment groups: rifaximin 1600 mg (group 1); rifaximin 1200 mg (group 2). Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated. Results One drop-out was observed in group 1 and two in group 2. Glucose breath test normalization rate was significantly higher in group 1 with respect to group 2 both in intention-to-treat (80% vs. 58%; P < 0.05) and per protocol analysis (82% vs. 61%; P < 0.05). No significant differences in patient compliance and incidence of side effects were found between groups. Conclusions Rifaximin 1600 mg/day showed a significantly higher efficacy for small intestinal Bacterial Overgrowth treatment with respect to 1200 mg with similar compliance and side-effect profile.
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High dosage rifaximin for the treatment of small intestinal Bacterial Overgrowth.
Alimentary pharmacology & therapeutics, 2007Co-Authors: Emidio Scarpellini, Maurizio Gabrielli, Andrea Lupascu, Giovanni Gasbarrini, Giovanni Cammarota, C Lauritano, Giuseppe Merra, I A Cazzato, Antonio GasbarriniAbstract:ummary Background Rifaximin is a broad spectrum non-absorbable antibiotic used for treatment of small intestinal Bacterial Overgrowth. Doses of 1200 mg/day showed a decontamination rate of 60% with low side-effects incidence. Aims To assess efficacy, safety and tolerability of rifaximin 1600 mg with respect to 1200 mg/day for small intestinal Bacterial Overgrowth treatment. Methods Eighty consecutive small intestinal Bacterial Overgrowth patients were enrolled. Diagnosis of small intestinal Bacterial Overgrowth based the clinical history and positivity to H2/CH4 glucose breath test. Patients were randomized in two 7-day treatment groups: rifaximin 1600 mg (group 1); rifaximin 1200 mg (group 2). Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated. Results One drop-out was observed in group 1 and two in group 2. Glucose breath test normalization rate was significantly higher in group 1 with respect to group 2 both in intention-to-treat (80% vs. 58%; P
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hydrogen glucose breath test to detect small intestinal Bacterial Overgrowth a prevalence case control study in irritable bowel syndrome
Alimentary Pharmacology & Therapeutics, 2005Co-Authors: Andrea Lupascu, Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Giovanni Cammarota, Angelo Santoliquido, Paolo Tondi, Paolo Pola, R Flore, G GasbarriniAbstract:Summary Background: Studies assessing the prevalence of small intestinal Bacterial Overgrowth in irritable bowel syndrome gave contrasting results. Differences in criteria to define irritable bowel syndrome patients and methods to assess small intestinal Bacterial Overgrowth may explain different results. Moreover, no data exist on small intestinal Bacterial Overgrowth prevalence in a significant population of healthy non-irritable bowel syndrome subjects. Aim: To assess the prevalence of small intestinal Bacterial Overgrowth by glucose breath test in patients with irritable bowel syndrome symptoms with respect to a consistent control group. Methods: Consecutive patients with irritable bowel syndrome according to Rome II criteria were enrolled. The control population consisted of 102 sex- and age-matched healthy subjects without irritable bowel syndrome symptoms. All subjects underwent glucose breath test. A peak of H2 values >10 p.p.m above the basal value after 50 g of glucose ingestion was considered suggestive of small intestinal Bacterial Overgrowth. Results: A total of 65 irritable bowel syndrome patients and 102 healthy controls were enrolled. Positivity to glucose breath test was found in 31% of irritable bowel syndrome patients with respect to 4% in the control group, the difference between groups resulting statistically significant (OR: 2.65; 95% CI: 3.5–33.7, P < 0.00001). Conclusions: The present case–control study showed an epidemiological association between irritable bowel syndrome and small intestinal Bacterial Overgrowth. Placebo-controlled small intestinal Bacterial Overgrowth-eradication studies are necessary to clarify the real impact of small intestinal Bacterial Overgrowth on irritable bowel syndrome symptoms.
Giovanni Cammarota - One of the best experts on this subject based on the ideXlab platform.
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Fecal calprotectin concentrations in patients with small intestinal Bacterial Overgrowth.
Digestive diseases (Basel Switzerland), 2008Co-Authors: Massimo Montalto, Emidio Scarpellini, Giovanni Cammarota, Luca Santoro, Sara Dalvai, Valentina Curigliano, Ferruccio D'onofrio, Simona Panunzi, Antonella Gallo, Antonio GasbarriniAbstract:Background/Aims: Small intestinal Bacterial Overgrowth (SIBO) is defined by any condition in which the proximal part of the small bowel harbors for a long time >105 bacte
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Association between hypothyroidism and small intestinal Bacterial Overgrowth.
The Journal of clinical endocrinology and metabolism, 2007Co-Authors: Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Anna Lisa Bilotta, Antonio Laginestra, Marialuisa Novi, S. Sottili, Michele Serricchio, Giovanni CammarotaAbstract:Objectives: Small intestinal Bacterial Overgrowth is defined as an abnormally high Bacterial population level in the small intestine. Intestinal motor dysfunction associated with hypothyroidism could predispose to Bacterial Overgrowth. Luminal bacteria could modulate gastrointestinal symptoms and interfere with levothyroxine absorption. The aims of the present study were to assess the prevalence and clinical pattern of Bacterial Overgrowth in patients with a history of overt hypothyroidism and the effects of Bacterial Overgrowth decontamination on thyroid hormone levels. Methods: A total of 50 consecutive patients with a history of overt hypothyroidism due to autoimmune thyroiditis was enrolled. Diagnosis of Bacterial Overgrowth was based on positivity to a hydrogen glucose breath test. Bacterial Overgrowth positive patients were treated with 1200 mg rifaximin each day for a week. A glucose breath test, gastrointestinal symptoms, and thyroid hormone plasma levels were reassessed 1 month after treatment. R...
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high dosage rifaximin for the treatment of small intestinal Bacterial Overgrowth
Alimentary Pharmacology & Therapeutics, 2007Co-Authors: Emidio Scarpellini, Maurizio Gabrielli, Andrea Lupascu, Giovanni Gasbarrini, Giovanni Cammarota, C Lauritano, Giuseppe Merra, I A Cazzato, Antonio GasbarriniAbstract:ummary Background Rifaximin is a broad spectrum non-absorbable antibiotic used for treatment of small intestinal Bacterial Overgrowth. Doses of 1200 mg/day showed a decontamination rate of 60% with low side-effects incidence. Aims To assess efficacy, safety and tolerability of rifaximin 1600 mg with respect to 1200 mg/day for small intestinal Bacterial Overgrowth treatment. Methods Eighty consecutive small intestinal Bacterial Overgrowth patients were enrolled. Diagnosis of small intestinal Bacterial Overgrowth based the clinical history and positivity to H2/CH4 glucose breath test. Patients were randomized in two 7-day treatment groups: rifaximin 1600 mg (group 1); rifaximin 1200 mg (group 2). Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated. Results One drop-out was observed in group 1 and two in group 2. Glucose breath test normalization rate was significantly higher in group 1 with respect to group 2 both in intention-to-treat (80% vs. 58%; P < 0.05) and per protocol analysis (82% vs. 61%; P < 0.05). No significant differences in patient compliance and incidence of side effects were found between groups. Conclusions Rifaximin 1600 mg/day showed a significantly higher efficacy for small intestinal Bacterial Overgrowth treatment with respect to 1200 mg with similar compliance and side-effect profile.
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High dosage rifaximin for the treatment of small intestinal Bacterial Overgrowth.
Alimentary pharmacology & therapeutics, 2007Co-Authors: Emidio Scarpellini, Maurizio Gabrielli, Andrea Lupascu, Giovanni Gasbarrini, Giovanni Cammarota, C Lauritano, Giuseppe Merra, I A Cazzato, Antonio GasbarriniAbstract:ummary Background Rifaximin is a broad spectrum non-absorbable antibiotic used for treatment of small intestinal Bacterial Overgrowth. Doses of 1200 mg/day showed a decontamination rate of 60% with low side-effects incidence. Aims To assess efficacy, safety and tolerability of rifaximin 1600 mg with respect to 1200 mg/day for small intestinal Bacterial Overgrowth treatment. Methods Eighty consecutive small intestinal Bacterial Overgrowth patients were enrolled. Diagnosis of small intestinal Bacterial Overgrowth based the clinical history and positivity to H2/CH4 glucose breath test. Patients were randomized in two 7-day treatment groups: rifaximin 1600 mg (group 1); rifaximin 1200 mg (group 2). Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated. Results One drop-out was observed in group 1 and two in group 2. Glucose breath test normalization rate was significantly higher in group 1 with respect to group 2 both in intention-to-treat (80% vs. 58%; P
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hydrogen glucose breath test to detect small intestinal Bacterial Overgrowth a prevalence case control study in irritable bowel syndrome
Alimentary Pharmacology & Therapeutics, 2005Co-Authors: Andrea Lupascu, Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Giovanni Cammarota, Angelo Santoliquido, Paolo Tondi, Paolo Pola, R Flore, G GasbarriniAbstract:Summary Background: Studies assessing the prevalence of small intestinal Bacterial Overgrowth in irritable bowel syndrome gave contrasting results. Differences in criteria to define irritable bowel syndrome patients and methods to assess small intestinal Bacterial Overgrowth may explain different results. Moreover, no data exist on small intestinal Bacterial Overgrowth prevalence in a significant population of healthy non-irritable bowel syndrome subjects. Aim: To assess the prevalence of small intestinal Bacterial Overgrowth by glucose breath test in patients with irritable bowel syndrome symptoms with respect to a consistent control group. Methods: Consecutive patients with irritable bowel syndrome according to Rome II criteria were enrolled. The control population consisted of 102 sex- and age-matched healthy subjects without irritable bowel syndrome symptoms. All subjects underwent glucose breath test. A peak of H2 values >10 p.p.m above the basal value after 50 g of glucose ingestion was considered suggestive of small intestinal Bacterial Overgrowth. Results: A total of 65 irritable bowel syndrome patients and 102 healthy controls were enrolled. Positivity to glucose breath test was found in 31% of irritable bowel syndrome patients with respect to 4% in the control group, the difference between groups resulting statistically significant (OR: 2.65; 95% CI: 3.5–33.7, P < 0.00001). Conclusions: The present case–control study showed an epidemiological association between irritable bowel syndrome and small intestinal Bacterial Overgrowth. Placebo-controlled small intestinal Bacterial Overgrowth-eradication studies are necessary to clarify the real impact of small intestinal Bacterial Overgrowth on irritable bowel syndrome symptoms.
Emidio Scarpellini - One of the best experts on this subject based on the ideXlab platform.
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Prevalence of Small Intestinal Bacterial Overgrowth in Parkinson's Disease†
Movement disorders : official journal of the Movement Disorder Society, 2011Co-Authors: Maurizio Gabrielli, Ernesto Cristiano Lauritano, Emidio Scarpellini, Patrizia Bonazzi, E. Bendia, Alfonso Fasano, Maria Gabriella Ceravolo, Marianna Capecci, Anna Rita Bentivoglio, Leandro ProvincialiAbstract:Background: Parkinson's disease (PD) is associated with gastrointestinal motility abnormalities that could favor the occurrence of small intestinal Bacterial Overgrowth. The aim of the study was to assess the prevalence of small intestinal Bacterial Overgrowth in PD patients. Methods: Consecutive PD patients were enrolled. The controls were subjects without PD. All patients and controls underwent the glucose breath test to assess small intestinal Bacterial Overgrowth. Results: Forty-eight PD patients and 36 controls were enrolled. The prevalence of small intestinal Bacterial Overgrowth was significantly higher in PD patients than in controls (54.17% vs 8.33%; P < .0001; OR, 2.24; 95% CI, 3.50–48.24). Multivariate analysis showed Hoehn and Yahr stage (OR, 3.07; 95% CI, 1.14–8.27) and Unified PD Rating score (OR, 1.12; 95% CI, 1.02–1.23) were significantly associated with small intestinal Bacterial Overgrowth in PD patients. Conclusions: Small intestinal Bacterial Overgrowth is highly prevalent in PD. Gastrointestinal motility abnormalities might explain this association. © 2011 Movement Disorder Society
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Antibiotic therapy in small intestinal Bacterial Overgrowth: rifaximin versus metronidazole
European review for medical and pharmacological sciences, 2009Co-Authors: Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Veronica Ojetti, Davide Roccarina, Alessia Villita, E Fiore, Roberto Flore, Angelo Santoliquido, Paolo TondiAbstract:Background and objectives Few controlled trials on antibiotic therapy for small intestinal Bacterial Overgrowth are available at present. Aim of the study was to assess efficacy, safety and tolerability of rifaximin with respect to metronidazole for the treatment of small intestinal Bacterial Overgrowth. Material and methods We enrolled 142 consecutive patients with diagnosis of small intestinal Bacterial Overgrowth. Diagnosis of small intestinal Bacterial Overgrowth based on the clinical history and the positivity of glucose breath test. Patients were randomised to two 7-day treatment groups: rifaximin 1200 mg/day and metronidazole 750 mg/day. Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated. Results One drop-out was observed in rifaximin group. Five drops-out occurred in metronidazole group. The glucose breath test normalization rate was significantly higher in the rifaximin with respect to the metronidazole group (63.4% versus 43.7%; p Discussion Rifaximin showed an higher SIBO decontamination rate than metronidazole at the tested doses, both with a significant gain in terms of tolerability. Either the present study or recent evidencies suggest that rifaximin represents a good choice for the management of patients affected by SIBO.
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Fecal calprotectin concentrations in patients with small intestinal Bacterial Overgrowth.
Digestive diseases (Basel Switzerland), 2008Co-Authors: Massimo Montalto, Emidio Scarpellini, Giovanni Cammarota, Luca Santoro, Sara Dalvai, Valentina Curigliano, Ferruccio D'onofrio, Simona Panunzi, Antonella Gallo, Antonio GasbarriniAbstract:Background/Aims: Small intestinal Bacterial Overgrowth (SIBO) is defined by any condition in which the proximal part of the small bowel harbors for a long time >105 bacte
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Small intestinal Bacterial Overgrowth: diagnosis and treatment.
Digestive Diseases, 2007Co-Authors: Antonio Gasbarrini, Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Veronica Ojetti, Giovanni GasbarriniAbstract:Small intestinal Bacterial Overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine. The main mechanisms restricting Bacterial colonization in the upper gut are the gastric acid barrier, mucosal and systemic immunity and intestinal clearance. When these mechanisms fail, Bacterial Overgrowth develops. Diarrhea, steatorrhea, chronic abdominal pain, bloating and flatulence are common symptoms and are similar to those observed in irritable bowel syndrome. Breath tests (glucose and/or lactulose breath tests) have been proposed as a sensitive and simple tool for the diagnosis of Bacterial Overgrowth, being non-invasive and inexpensive compared to the gold standard represented by the culture of intestinal aspirates. Antibiotic therapy is the cornerstone of SIBO treatment. Current SIBO treatment is based on empirical courses of broad-spectrum antibiotics since few controlled studies concerning the choice and duration of antibiotic therapy are available at present.
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Association between hypothyroidism and small intestinal Bacterial Overgrowth.
The Journal of clinical endocrinology and metabolism, 2007Co-Authors: Ernesto Cristiano Lauritano, Maurizio Gabrielli, Emidio Scarpellini, Andrea Lupascu, Anna Lisa Bilotta, Antonio Laginestra, Marialuisa Novi, S. Sottili, Michele Serricchio, Giovanni CammarotaAbstract:Objectives: Small intestinal Bacterial Overgrowth is defined as an abnormally high Bacterial population level in the small intestine. Intestinal motor dysfunction associated with hypothyroidism could predispose to Bacterial Overgrowth. Luminal bacteria could modulate gastrointestinal symptoms and interfere with levothyroxine absorption. The aims of the present study were to assess the prevalence and clinical pattern of Bacterial Overgrowth in patients with a history of overt hypothyroidism and the effects of Bacterial Overgrowth decontamination on thyroid hormone levels. Methods: A total of 50 consecutive patients with a history of overt hypothyroidism due to autoimmune thyroiditis was enrolled. Diagnosis of Bacterial Overgrowth was based on positivity to a hydrogen glucose breath test. Bacterial Overgrowth positive patients were treated with 1200 mg rifaximin each day for a week. A glucose breath test, gastrointestinal symptoms, and thyroid hormone plasma levels were reassessed 1 month after treatment. R...