The Prevalence of Small Intestinal Bacterial Overgrowth After Roux-en-Y Gastric Bypass (RYGB): a Systematic Review and Meta-analysis

Obes Surg. 2024 Jan;34(1):250-257. doi: 10.1007/s11695-023-06974-9. Epub 2023 Dec 7.

Abstract

We reviewed the literature on the prevalence of small intestinal bacterial overgrowth (SIBO) after Roux-en-Y gastric bypass (RYGB). Eight studies examining 893 patients were included. The mean age of the patients was 48.11 ± 4.89 years. The mean BMI before surgery and at the time of SIBO diagnosis was 44.57 ± 2.89 kg/m2 and 31.53 ± 2.29 kg/m2, respectively. Moreover, the results showed a 29% and 53% prevalence of SIBO at < 3-year and > 3-year follow-up after RYGB, respectively. Symptoms included abdominal pain, diarrhea, bloating, nausea, vomiting, constipation, soft stool, frequent defecation, flatulence, rumpling, dumping syndrome, and irritable bowel syndrome. SIBO is prevalent after RYGB; digestive symptoms should prompt the consideration of SIBO as a potential etiology. Antibiotic therapy has proven to be therapeutic.

Keywords: Adjustable gastric band; Bacterial overgrowth; Bariatric surgery; Biliopancreatic diversion with duodenal switch; Hydrogen breath test; Metabolic surgery; Prevalence; Roux-en-Y gastric bypass; Sleeve gastrectomy; Small intestinal bacterial overgrowth.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Biliopancreatic Diversion* / methods
  • Flatulence
  • Gastrectomy / methods
  • Gastric Bypass* / adverse effects
  • Gastric Bypass* / methods
  • Humans
  • Middle Aged
  • Obesity, Morbid* / surgery
  • Prevalence
  • Retrospective Studies