Increased gastrointestinal transit time is present in most people with PD early during the course of the disease, predisposing to gut dysbiosis, including SIBO. Sporadic forms may start in the gut years before the development of clinical features. Parkinson’s disease (PD) is a common neurodegenerative proteinopathy for which disease modifying interventions are not available.

SIBO can be eradicated by one or several courses of antibiotics but reappears if the predisposing condition persists. Intestinal inflammation, malabsorption and vitamin imbalances may also develop. Though not a disease, it may result in intestinal symptoms caused by the accumulation of microbial gases in the intestine. Small intestinal bacterial overgrowth (SIBO) is a gut dysbiosis in which the small intestine is abundantly colonized by bacteria that are typically found in the colon. Increasing evidence suggests that the gut microbiota and the brain are closely connected via the so-called gut–brain axis. The results reveal a clear relationship between the oral microbiota and the duodenal microbiota and suggest an association between the absolute abundance of disruptor taxa, SIBO, and the prevalence of severe GI symptoms. This study provides the largest dataset of the absolute abundance of microbiota from the human duodenum to date. Absolute loads of disruptors were associated with more severe GI symptoms, highlighting the value of absolute taxon quantification when studying small-intestine health and function. Disruptor taxa were enriched in samples with high total microbial loads and in individuals with small intestinal bacterial overgrowth (SIBO). Several taxa, including Klebsiella, Escherichia, Enterococcus, and Clostridium, seemed to displace strict anaerobes common in the duodenum, so we refer to these taxa as disruptors. Paired saliva-duodenum samples suggested potential transmission of oral microbes to the duodenum, including organisms from the HACEK group. Log-transformed total microbial loads spanned 5 logs and were normally distributed. Using quantitative sequencing, we evaluated total and taxon-specific absolute microbial loads from 250 duodenal-aspirate samples and 21 paired duodenum-saliva samples from participants in the REIMAGINE study. The small intestine is the major site for immune surveillance in the gut, and compared with the large intestine, it has greater than 100 times the surface area and a thinner and more permeable mucus layer. Although large-intestine microbiota have been linked to several GI diseases, the microbiota of the human small intestine and its relation to human disease has been understudied. Upper gastrointestinal (GI) disorders and abdominal pain afflict between 12 and 30% of the worldwide population and research suggests these conditions are linked to the gut microbiome. Early recognition and diagnosis of SIBO is critical in minimizing patient morbidity and mortality. Presentation of severe SIBO in the setting of intestinal stasis secondary to gastric outlet after initiation of enteral feeds is a rare phenomenon. Histologic findings were consistent with SIBO. Surgical exploration confirmed segmental bowel necrosis requiring resection.

Imaging revealed diffuse pneumatosis and portal venous gas. Here we describe a severe case of SIBO leading to small bowel necrosis requiring surgical intervention.Ī 55-year-old Hispanic female with gastric outlet obstruction secondary to a newly diagnosed gastric adenocarcinoma, receiving neoadjuvant chemotherapy, developed bloody gastrostomy output and rapidly progressing nausea and abdominal distention 3 days after jejunostomy tube placement and initiation of jejunal enteral nutrition. Small intestinal bacterial overgrowth (SIBO) is a condition of unknown prevalence characterized by an excessive amount of bacteria in the small bowel, typically resulting in vague gastrointestinal symptoms with bloating being most commonly reported.

Small intestine bacterial overgrowth