Small-bowel aspiration during upper esophagogastroduodenoscopy: Rao technique

Published on Apr 1, 2021in VideoGIE
· DOI :10.1016/J.VGIE.2020.11.008
Tennekoon Karunaratne4
Estimated H-index: 4
Amol Sharma19
Estimated H-index: 19
Satish S.C. Rao79
Estimated H-index: 79
#1Mark Pimentel (Cedars-Sinai Medical Center)H-Index: 61
#2Richard J. Saad (UM: University of Michigan)H-Index: 20
Last. Satish S.C. RaoH-Index: 79
view all 4 authors...
Small intestinal bacterial overgrowth is defined as the presence of excessive numbers of bacteria in the small bowel, causing gastrointestinal symptoms. This guideline statement evaluates criteria for diagnosis, defines the optimal methods for diagnostic testing, and summarizes treatment options for small intestinal bacterial overgrowth. This guideline provides an evidence-based evaluation of the literature through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) pr...
51 CitationsSource
Small intestinal bacterial overgrowth (SIBO) is a common, yet underrecognized, problem. Its prevalence is unknown because SIBO requires diagnostic testing. Although abdominal bloating, gas, distension, and diarrhea are common symptoms, they do not predict positive diagnosis. Predisposing factors inc
23 CitationsSource
#1George Saffouri (Mayo Clinic)H-Index: 3
#2Robin R. Shields-Cutler (Macalester College)H-Index: 9
Last. Purna C. Kashyap (Mayo Clinic)H-Index: 33
view all 24 authors...
Small intestinal bacterial overgrowth (SIBO) has been implicated in symptoms associated with functional gastrointestinal disorders (FGIDs), though mechanisms remain poorly defined and treatment involves non-specific antibiotics. Here we show that SIBO based on duodenal aspirate culture reflects an overgrowth of anaerobes, does not correspond with patient symptoms, and may be a result of dietary preferences. Small intestinal microbial composition, on the other hand, is significantly altered in sy...
50 CitationsSource
#1Jigar Bhagatwala (Georgia Regents University)H-Index: 12
#2Satish S.C. RaoH-Index: 79
Abstract Millions of patients in the United States and across the world suffer from unexplained yet common gastrointestinal symptoms such as abdominal pain, bloating, gas, indigestion, diarrhea and nausea. An underrecognized cause of these symptoms is small intestinal bacterial and/or fungal overgrowth. These conditions are not only common but their prevalence is rising. Several conditions and risk factors have been identified, in particular altered gut anatomy such as Intestinal by pass surgery...
1 CitationsSource
#1Satish S.C. Rao (Georgia Regents University)H-Index: 79
#2Abdul Rehman (Georgia Regents University)H-Index: 4
Last. Nicole Martinez de Andino (Georgia Regents University)H-Index: 2
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D-lactic acidosis is characterized by brain fogginess (BF) and elevated D-lactate and occurs in short bowel syndrome. Whether it occurs in patients with an intact gut and unexplained gas and bloating is unknown. We aimed to determine if BF, gas and bloating is associated with D-lactic acidosis and small intestinal bacterial overgrowth (SIBO). Patients with gas, bloating, BF, intact gut, and negative endoscopic and radiological tests, and those without BF were evaluated. SIBO was assessed with gl...
43 CitationsSource
After subtotal colectomy, 40% of patients report chronic gastrointestinal symptoms and poor quality of life. Its etiology is unknown. We determined whether small intestinal bacterial overgrowth (SIBO) or small intestinal fungal overgrowth (SIFO) cause gastrointestinal symptoms after colectomy. Consecutive patients with unexplained abdominal pain, gas, bloating and diarrhea (>1 year), and without colectomy (controls), and with colectomy were evaluated with symptom questionnaires, glucose breath t...
14 CitationsSource
#1Ali Rezaie (Cedars-Sinai Medical Center)H-Index: 32
#2Michelle Buresi (U of C: University of Calgary)H-Index: 8
Last. Mark Pimentel (Cedars-Sinai Medical Center)H-Index: 61
view all 10 authors...
Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus
259 CitationsSource
Gut microbiota is the largest organ of the human body. Although growth of bacteria more than 105 colony forming unit (CFU) per milliliter in culture of upper gut aspirate is used to diagnosis small intestinal bacterial overgrowth (SIBO), 103 CFU or more is being considered to suggest the diagnosis, particularly if colonic type bacteria are present in the upper gut. Although neither very sensitive nor specific, hydrogen breath tests are widely used to diagnose SIBO. Rifaximin is the best treatmen...
36 CitationsSource
#1Ron Sender (Weizmann Institute of Science)H-Index: 5
#2Shai Fuchs (Weizmann Institute of Science)H-Index: 6
Last. Ron Milo (Weizmann Institute of Science)H-Index: 73
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Reported values in the literature on the number of cells in the body differ by orders of magnitude and are very seldom supported by any measurements or calculations. Here, we integrate the most up-to-date information on the number of human and bacterial cells in the body. We estimate the total number of bacteria in the 70 kg "reference man" to be 3.8·1013. For human cells, we identify the dominant role of the hematopoietic lineage to the total count (≈90%) and revise past estimates to 3.0·1013 h...
1,705 CitationsSource
#1Uday C. Ghoshal (SGPGIMS: Sanjay Gandhi Post Graduate Institute of Medical Sciences)H-Index: 56
Last. Ujjala GhoshalH-Index: 26
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Antibiotics relieve symptoms in half of the unselected patients with irritable bowel syndrome (IBS); however, their efficacy if selected according to small-intestinal bacterial overgrowth (SIBO) is unknown.The aim of this study was to evaluate (a) symptom resolution among IBS patients with or without SIBO on norfloxacin treatment, and (b) its efficacy in obtaining negative SIBO test results as compared with placebo.Eighty IBS patients (Rome III) were evaluated for SIBO by gut aspirate culture. P...
39 CitationsSource
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