January 24, 2023 healthcare

30% of diabetic patients in Kuwait have SIBO: Expert


KUWAIT: Consultant of internal diseases, digestive system and liver Dr Wafaa Al-Hashash said around 30 percent of diabetic patients in Kuwait have small intestinal bacterial overgrowth (SIBO), adding this is equivalent to around 340,000 people in the country. She said the elderly are more prone to the risk of getting SIBO due to the change in level of stomach acid, and most of them are taking medicines that exacerbate the risk.

Dr Hashash said SIBO occurs when there is an abnormal increase in the total number of bacteria in the small intestine, adding that in case of SIBO, food stagnates in the small intestine and becomes a fertile medium for bacterial growth, resulting in toxins that affect absorption of nutrients. This will result in symptoms, most important of which are gases, flatulence and diarrhea even after eating a small portion of food.

She said among the most important symptoms of SIBO are abdominal pain, nausea, gas and weight loss, adding that among the factors of getting SIBO are surgeries of the abdomen, such as gastric sleeve operations, gastric bypass, peptic ulcer surgeries, small bowel adhesions and diverticulitis in intestines, as well as getting celiac disease, diabetes radiation enteritis or cases that slow the movement of intestines.

Dr Hashash said SIBO is diagnosed through breathing with hydrogen and methane, with the accuracy of the test up to 83 percent. The system measures the amount of hydrogen and methane the person exhales, indicating overgrowth of bacteria in the small intestine. There is also a blood test to look for vitamin deficiency and a fecal test to check for bad fat absorption. She said sometimes an x-ray, CT scan or MRI is taken to check for abnormalities in the structure of intestines.

Dr Hashash said among SIBO complications is bad absorption of fats, carbohydrates and proteins, in addition to vitamin and basic mineral deficiency. It also leads to osteoporosis and formation of kidney stones due to bad absorption of calcium. She said it is necessary to treat the main cause of SIBO by antibiotics to reduce the number of harmful bacteria.

But this is a short-term treatment because bacteria may return when the antibiotic is stopped, so the doctor should change the medicine to protect against bacterial resistance. She indicated treatment by nutritional support is the most important step to compensate for vitamin deficiency and weight loss, in addition to using food supplements and a fiber-rich diet.

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