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Volume 7, Issue 7 (Suppl)

J Gastrointest Dig Syst

ISSN: 2161-069X JGDS, an open access journal

Gastroenterologists 2017

December 14-15, 2017

December 14-15, 2017 Dubai, UAE

World

Gastroenterologists Summit

Small intestine bacterial overgrowth: A major biomarker in the pathogenesis of environmental

enteropathy (EE)

Ulysses Fagundes-Neto

Universidade Federal de São Paulo, Brazil

E is a subclinical disorder that affects children usually of low income families who live in environments with poor sanitation

and hygiene. EE is nowwidely recognized to be themajor contributor to childhoodmalnutrition. EE is marked by alterations

of the digestive-absorptive function and morphological abnormalities of the jejunal mucosa, such as villous flattening, crypt

hyperplasia and increased inflammatory infiltration in the lamina propria. Small intestine bacterial overgrowth (SIBO) by

the colonic type of bacteria has been reported in children of low income families in several different developing countries.

The metabolism of these proliferating bacterial flora leads to de-conjugation and 7-alpha de-hydroxylation of the primary

bile salts; colic and chenodeoxycholic transforming them in secondary bile salts, deoxycholic and lithocolic, respectively.

These de-conjugated and secondary bile salts are injurious to the jejunal mucosa able to induce sodium and water secretion,

carbohydrate mal-absorption, morphological damage and even rupture of the intestinal permeability barrier. Considering that

SIBO plays a very important role in the pathogenesis of EE, it becomes mandatory to search its presence when suspected. There

are two well-known biomarker tests available to investigate SIBO, namely: (1) Invasive: Jejunal fluid culture for aerobic and

anaerobic bacteria; (2) Non-invasive: Hydrogen breath test utilizing lactulose, a non-absorbable carbohydrate, as a substrate.

The objective of this presentation is to describe our experience utilizing these biomarkers in Brazilian children living in various

different communities of low income families with lack of basic sanitary conditions.

J Gastrointest Dig Syst 2017, 7:7 (Suppl)

DOI: 10.4172/2161-069X-C1-062