Brechmann T, Sperlbaum A, Schmiegel W. Levothyroxine therapy and impaired clearance are the strongest contributors to small intestinal bacterial overgrowth: Results of a retrospective cohort study. World J Gastroenterol 2017; 23(5): 842-852 [PMID: 28223728 DOI: 10.3748/wjg.v23.i5.842]
Corresponding Author of This Article
Thorsten Brechmann, MD, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. thorsten.brechmann@rub.de
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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Brechmann T, Sperlbaum A, Schmiegel W. Levothyroxine therapy and impaired clearance are the strongest contributors to small intestinal bacterial overgrowth: Results of a retrospective cohort study. World J Gastroenterol 2017; 23(5): 842-852 [PMID: 28223728 DOI: 10.3748/wjg.v23.i5.842]
World J Gastroenterol. Feb 7, 2017; 23(5): 842-852 Published online Feb 7, 2017. doi: 10.3748/wjg.v23.i5.842
Levothyroxine therapy and impaired clearance are the strongest contributors to small intestinal bacterial overgrowth: Results of a retrospective cohort study
Thorsten Brechmann, Andre Sperlbaum, Wolff Schmiegel
Thorsten Brechmann, Andre Sperlbaum, Wolff Schmiegel, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany
Author contributions: Brechmann T was guarantor of the article; contributed to conception and design of the study, data analysis and interpretation, supervision, drafting the manuscript; Sperlbaum A contributed to conducting the study, acquisition of data, analysis and interpretation; Schmiegel W contributed to supervision, revision of the manuscript, support in terms of gastroenterology; all authors approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Ruhr-University Bochum (Registration number: 4864-13).
Conflict-of-interest statement: The authors declare that there is no actual or potential conflict of interest related to the work.
Correspondence to: Thorsten Brechmann, MD, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. thorsten.brechmann@rub.de
Telephone: +49-234-3023411 Fax: +49-234-3026707
Received: August 26, 2016 Peer-review started: August 28, 2016 First decision: October 20, 2016 Revised: October 22, 2016 Accepted: November 16, 2016 Article in press: November 16, 2016 Published online: February 7, 2017 Processing time: 149 Days and 9 Hours
Core Tip
Core tip: Several contributors to small intestinal overgrowth have been described, but the impact of particular risk factors is poorly understood. We aimed to determine the influence of several pathomechanisms, such as impaired gastric acid barrier function, impaired intestinal clearance, impairment of defence mechanisms and miscellaneous factors, as well as to weight and rank a large set of potential contributors by means of a retrospective cohort study of 1809 consecutive patients who had undergone a hydrogen breath test to rule out small intestinal bacterial overgrowth. Overall, levothyroxine therapy, impaired intestinal clearance and immunosuppression are the strongest contributors, while an impaired gastric acid barrier only plays a minor role.
