Eradication of small intestinal bacterial overgrowth and oro-cecal transit in diabetics.

BACKGROUND/AIMS: Gastrointestinal motility disorders are often present in diabetic patients. Even if this problem has been attributed to autonomic neuropathy, the pathophysiological mechanisms responsible are not completely defined. Aim of our study was to evaluate the effect of eradication of small-intestine bacterial overgrowth on oro-cecal transit time in diabetic patients in order to identify a possible role of bacterial overgrowth on dysmotility. METHODOLOGY: We selected among 74 diabetic patients who underwent H2-lactulose breath test, 21 subjects (13M, 8F, mean age 43.7 years, 11 with type 1 and 10 with type 2 diabetes) affected by bacterial overgrowth and delayed oro-cecal transit time and with normal cardiovascular autonomic test. Patients were treated with rifaximin and underwent a control breath test. Data were analyzed using paired-data t-test. RESULTS: Three patients still showed bacterial overgrowth, 5 persistent delayed transit time without bacterial overgrowth; 13 patients (62%) showed a significant (P < 0.001) reduction of on oro-cecal transit time without bacterial overgrowth. CONCLUSIONS: Our results show that bacterial overgrowth may contribute to the delay of intestinal transit as confirmed by its significant improvement after eradication therapy.