P0141 PP THE PROFILE OF THE CONJUGATED BILE ACIDS IN DUODENAL CONTENTS IN CHILDREN WITH GASTROESOPHAGEAL REFLUX AND SMALL INTESTINE BACTERIAL OVERGROWTH

Abstract

Introduction: As presented recently, the small intestine bacterial overgrowth (SIBO) may play a role in the pathogenesis of the pathological gastroesophageal reflux (pGER). The etiology of SIBO related pGER is unknown: possible role of the increase of the secondary bile acids level as the inducing factor of pGER is suspected. Aim of the study. The assessment of the bile acid profile in the duodenal contents in children with SIBO and pGER. Methods: Thirty two children entered the study. All of them had the esophageal 24-h pH probe, lactulose breath hydrogen test (LBHT) and duodenal tube for microbiological and biochemical analysis of the duodenal contents. SIBO was diagnosed base on results of LBHT and microbiological analysis of the duodenal contents and pGER was diagnosed according to DeMeester criteria. Then 3 groups of patients were defined: Group I: 13 children with SIBO and pGER Group II: 10 children with SIBO but no pGER Group III: 7 children without SIBO and pGER (Two children with pGER but without SIBO were excluded from the study). The bile acids profile in the duodenal contents was assessed using the high performance liquid chromatography. We analyzed percentage of the main primary (cholic, chenodeoxycholic) and secondary (deoxycholic) bile acids conjugated with taurine and glycine. Results: The percentage of total deoxycholic acid and its fraction conjugated with glycine was significantly lower in group II comparing to the group I (p<0,0005). No other statistically significant differences were found.Table 1: Mean percentage of bile acidsConclusion: We postulate the disturbances of bile acids contents, especially increase level of the secondary bile acids conjugated with glycine may play the role as the inducing factor for pGER in children with small intestine bacterial overgrowth.