Vibrio cholerae is a highly acid sensitive pathogen. Normal gastric pH in humans serves as a barrier to disease. Anatomical changes following gastric bypass surgery cause hypochlorhydria and thereby may predispose patients to acquire gastrointestinal infections. We describe a case of cholera in a 34-year-old woman following Roux-en-Y-gastric bypass.
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References
1.
OgdenCL, CarrollMD, KitBK, FlegalKM. Prevalence of obesity in the United States, 2009–2010. NCHS data brief, no 82. Hyattsville, MD: National Center for Health Statistics, 2012.
2.
LadduD, DowC, HingleM, ThomsonC, GoingS. A review of evidence based strategies to treat obesity in adults. Nutr Clin Pract, 2011; 26:512–25.
3.
CawleyJ, MeyerhoeferC. The medical care costs of obesity—an instrumental variables approach. J Health Econ, 2012; 31:219–230.
ShikoraSA, KimJJ, TarnoffME. Nutrition and gastrointestinal complications of bariatric surgery. Nutr Clin Pract, 2007; 22:29–40.
7.
Colaizzo-AnasT. Nutrient intake, digestion, absorption and excretion. GottschlichMM. The A.S.P.E.N Nutrition Support Core Curriculum: A Case-Based Approach—The Adult Patient. Silver Spring, MD: A.S.P.E.N., 2007; 3–18.
8.
SundbomM, MardhE, MardhS, OhrvallM, GustavssonS. Reduction in serum pepsinogen I after Roux-en-Y gastric bypass. J Gastrointest Surg, 2003; 7:529–535.
9.
GiannellaRA, BroitmanSA, ZamcheckN. Gastric acid barrier to ingested microorganisms in man: studies in vivo and in vitro. Gut, 1972; 13:251–256.
10.
TennantSM, HartlandEL, PhumoonnaT, LyrasD, RoodJI, Robins-BrownRMet al.Influence of gastric acid on susceptibility to infection with ingested bacterial pathogens. Infect Immun, 2008; 76:639–645.
11.
FredM, SiegristH, FreiR, FroehlichF, DurouxP, ThorensJet al.Duodenal bacterial overgrowth during treatment in outpatients with omeprazole. Gut, 1994; 35:23–26.
12.
ThorensJ, FroehlichF, SchwizerW, SaragaE, BilleJ, GyrKet al.Bacterial overgrowth during treatment with omeprazole compared with cimetidine: a prospective randomized double blind study. Gut, 1996; 39:54–59.
13.
GiannellaRA, BroitmanSA, ZamcheckN. Salmonella enteritis I. Role of reduced gastric section in pathogenesis. Am J Dig Dis, 1971; 16:1000–1006.
14.
GiannellaRA, BroitmanSA, ZamcheckN. Influence of gastric acidity on bacterial and parasitic enteric infections. A perspective. Ann Intern Med, 1973; 78:271–276.
YarbroughDR, McAlhanyJC, CooperN, WeidnerMG. Evaluation of the Heidelberg pH Capsule. Am J Surg, 1969; 117:185–192.
17.
RussellTL, BerardiRR, BarnettJL, DermentzoglouLC, JarvenpaaKM, SchmaltzSP, DressmanJB. Upper gastrointestinal pH in seventy-nine healthy, elderly, North American men and women. Pharm Res, 1993; 10:187–196.
18.
ClarkGWB, JamiesonJR, HinderRA, PolishukPV, DemeesterTR, GuptaN, ChengSC. The relationship between gastric pH and the emptying of solid, semisolid and liquid meals. Neurogastroenterol Motil, 1993; 5:273–279.
19.
MandalS, MadalMD, PalNK. Cholera: a great global concern. Asian Pac J Trop Med, 2011; 4:573–580.
