Dhotre SV, Dhotre PS, Nagoba BS. Letter to the Editor: From association to mechanism - advancing the understanding of small intestinal bacterial overgrowth in acute pancreatitis. World J Gastrointest Pharmacol Ther 2026; 17(3): 123931 [DOI: 10.4292/wjgpt.123931]
Corresponding Author of This Article
Basavraj S Nagoba, PhD, Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Vishwanathpuram, Ambajogai Road, Latur 413531, Maharashtra, India. dr_bsnagba@yahoo.com
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Gastroenterology & Hepatology
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letter
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World Journal of Gastrointestinal Pharmacology and Therapeutics
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2150-5349
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Dhotre SV, Dhotre PS, Nagoba BS. Letter to the Editor: From association to mechanism - advancing the understanding of small intestinal bacterial overgrowth in acute pancreatitis. World J Gastrointest Pharmacol Ther 2026; 17(3): 123931 [DOI: 10.4292/wjgpt.123931]
World J Gastrointest Pharmacol Ther. Sep 5, 2026; 17(3): 123931 Published online Sep 5, 2026. doi: 10.4292/wjgpt.123931
Letter to the Editor: From association to mechanism - advancing the understanding of small intestinal bacterial overgrowth in acute pancreatitis
Shree V Dhotre, Pradnya S Dhotre, Basavraj S Nagoba
Shree V Dhotre, Department of Microbiology, Ashwini Rural Medical College, Hospital and Research Centre, Solapur 413006, Maharashtra, India
Pradnya S Dhotre, Department of Biochemistry, Ashwini Rural Medical College, Hospital and Research Centre, Solapur 413006, Maharashtra, India
Basavraj S Nagoba, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, Maharashtra, India
Author contributions: Dhotre SV conceptualized the letter, critically appraised the index manuscript, and drafted the original text; Dhotre PS contributed to literature review, reference verification, and revision of the manuscript; Nagoba BS contributed to critical intellectual appraisal, scientific editing, and final approval of the manuscript; and all authors have read and approved the final version of the manuscript.
AI contribution statement: AI tools, specifically (ChatGPT & Grammarly), were used solely for language polishing and formatting assistance. No AI tool was used to generate research data, interpret results, or formulate conclusions.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Basavraj S Nagoba, PhD, Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Vishwanathpuram, Ambajogai Road, Latur 413531, Maharashtra, India. dr_bsnagba@yahoo.com
Received: June 2, 2026 Revised: July 20, 2026 Accepted: July 27, 2026 Published online: September 5, 2026 Processing time: 87 Days and 1.7 Hours
Abstract
Small intestinal bacterial overgrowth (SIBO) has emerged as a potential contributor to gastrointestinal dysfunction and systemic inflammation in acute pancreatitis (AP). The recent study by Kumbar et al provides important prospective evidence demonstrating a substantially higher prevalence of SIBO among patients with AP than healthy controls and identifies several clinical variables associated with bacterial overgrowth. Rather than reiterating the methodological limitations acknowledged by the authors, we discuss how these findings fit within the evolving understanding of the gut-pancreas axis and highlight emerging opportunities for precision microbiome research in AP. Particular attention is given to intestinal methanogen overgrowth, a biologically distinct entity that may influence intestinal motility, disease phenotype, and therapeutic response. We further outline future research priorities, including longitudinal microbiome profiling, integration of microbial biomarkers with clinical severity indices, and phenotype-directed therapeutic strategies. These perspectives extend the clinical implications of the index study and underscore the need to move beyond prevalence estimates toward mechanistic and translational investigations that clarify the causal role of microbial dysbiosis in AP.
Core Tip: The prospective study by Kumbar et al represents an important step toward understanding the relationship between small intestinal bacterial overgrowth and acute pancreatitis. Beyond confirming a high prevalence of small intestinal bacterial overgrowth, the findings raise broader questions regarding host-microbiome interactions, intestinal methanogen overgrowth, microbial biomarkers of disease severity, and precision therapeutic strategies. Future studies integrating breath testing with microbiome sequencing, metabolomic profiling, and longitudinal clinical assessment may determine whether microbial alterations are merely markers of disease severity or active contributors to pancreatic inflammation and systemic complications.
