International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: http://www.sciepub.com/journal/ijcd Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2014, 2(2), 67-69
DOI: 10.12691/ijcd-2-2-9
Open AccessCase Report

Should Small Intestine Bacterial Overgrowth be Ruled out as a Cause of Non-Responsive Celiac Disease?: A Case Report

Juan Lasa1, and Ignacio Zubiaurre1

1Gastroenterology Section, Internal Medicine Department. CEMIC, Buenos Aires, Argentina

Pub. Date: June 02, 2014

Cite this paper:
Juan Lasa and Ignacio Zubiaurre. Should Small Intestine Bacterial Overgrowth be Ruled out as a Cause of Non-Responsive Celiac Disease?: A Case Report. International Journal of Celiac Disease. 2014; 2(2):67-69. doi: 10.12691/ijcd-2-2-9

Abstract

Non-responsive celiac disease is defined as the persistency of symptoms, signs or laboratory abnormalities typical of CD despite 6-12 months of dietary gluten avoidance. Small intestine bacterial overgrowth has been classically considered a potential cause for non-responsive celiac disease. Nevertheless, the evidence regarding its prevalence among non-responsive celiac patients is conflicting, as well as the evidence showing a benefit in small intestine bacterial overgrowth treatment in this clinical setting. We report the case of a 34 year-old woman diagnosed with non-responsive celiac disease in spite of adequate gluten-free diet, that had complete resolution of symptoms after treatment with antibiotics for small intestine bacterial overgrowth.

Keywords:
celiac disease small intestine bacterial overgrowth diet Gluten-Free

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References:

[1]  Rubio-Tapia A., Hill I.D., Kelly C.P., Calderwood A.H., Murray J.A., “American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease”, Am J Gastroenterol, 2013. 108 (5). 656-76.
 
[2]  Leffler D.A., Dennis M., Hyett B., Kelly E., Schuppan D., Kelly C.P., “Etiologies and predictors of diagnosis in nonresponsive celiac disease”, Clin Gastroenterol Hepatol, 2007. 5 (4).445-50.
 
[3]  Abdulkarim A.S., Burgart L.J., See J., Murray J.A., “Etiology of nonresponsive celiac disease: results of a systematic approach”, Am J Gastroenterol, 2002. 97 (8). 2016-21.
 
[4]  Biagi F., Gobbi P., Marchese A., Borsotti E., Zingone F., Ciacci C., Volta U., Caio G., Carroccio A., Ambrosiano G., Mansueto P., Corazza G.R., “Low incidence but poor prognosis of complicated coeliac disease: a retrospective multicentre study”. Dig Liver Dis, 2014. 46 (3). 227-30.
 
[5]  Stewart M., Andrews C.N., Urbanski S., Beck P.L., Storr M., “The association of coeliac disease and microscopic colitis: a large population-based study”, Aliment Pharmacol Ther, 2011. 33 (12). 1340-9.
 
[6]  Chang M.S., Green P.H., “A review of rifaximin and bacterial overgrowth in poorly responsive celiac disease”, Therap Adv Gastroenterol, 2012. 5 (1). 31-6.
 
[7]  Khoshini R., Dai S.C., Lezcano S., Pimentel M., “A systematic review of diagnostic tests for small intestinal bacterial overgrowth”, Dig Dis Sci, 2008. 53 (6). 1443-54.
 
[8]  Pimentel M., Lembo A., Chey W.D., Zakko S., Ringel Y., Yu J., Mareya S.M., Shaw A.L., Bortey E., Forbes W.P., TARGET Study Group, “Rifaximin therapy for patients with irritable bowel syndrome without constipation”, N Engl J Med, 2011.6.364(1).22-32.
 
[9]  Ghoshal U.C., “How to interpret hydrogen breath tests”, J Neurogastroenterol Motil, 2011. 17 (3). 312-7.
 
[10]  Tursi A., Brandimarte G., Giorgetti G., “High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal”, Am J Gastroenterol, 2003. 98 (4). 839-43.
 
[11]  Ghoshal U.C., Ghoshal U., Misra A., Choudhuri G., “Partially responsive celiac disease resulting from small intestinal bacterial overgrowth and lactose intolerante”, BMC Gastroenterol, 2004. 4. 10.
 
[12]  Corazza G.R., Strocchi A., Gasbarrini G., “Fasting breath hydrogen in celiac Disease”, Gastroenterology, 1987. 93 (1). 53-8.
 
[13]  Rubio-Tapia A., Barton S.H., Rosenblatt J.E., Murray J.A., “Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease”, J Clin Gastroenterol, 2009. 43 (2). 157-61.
 
[14]  Chang M.S., Minaya M.T., Cheng J., Connor B.A., Lewis S.K., Green P.H., :Double-blind randomized controlled trial of rifaximin for persistent symptoms in patients with celiac disease”, Dig Dis Sci, 2011. 56 (10). 2939-46.