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Recognizing and treating a new entity on the quality-of-life front: small intestinal bacterial overgrowth
1 Gadsden Regional Cancer Center, Gadsden, AL; 2 Department of Radiation Oncology, University of Alabama–Birmingham, AL; and 3 Department of Medical Affairs, Salix Pharmaceuticals, Inc., Morrisville, NC
Gastrointestinal (GI) complications are widely recognized radiation-associated toxicities for patients undergoing cancer therapy. Emerging data suggest that small intestinal bacterial overgrowth (SIBO) contributes to numerous GI disorders. Recognizing this, our institution evaluates patients undergoing abdominopelvic radiotherapy (RT) for SIBO if they develop diarrhea or related symptoms. A retrospective case review was conducted over the initial 10-month period in which SIBO testing by glucose and lactulose breath tests was employed in the radiation oncology department. Of 30 patients with GI symptoms undergoing breath testing, 17 (57%) exhibited positive results consistent with SIBO. Sixteen patients with positive results and two with negative results, who were treated on an empiric basis, received rifaximin (Xifaxan) 800–1,200 mg/d during RT and for several weeks afterward. Of these patients, 94% and 81% experienced partial and global relief, respectively, of SIBO-associated GI symptoms. To our knowledge, this is the first published report demonstrating an association between SIBO and RT. Our findings emphasize the need to further examine the diagnosis and treatment of SIBO in this patient population.
| Commun Oncol 2007;4:625–628 | full text |  110 kb |