Background: Post-infectious irritable bowel syndrome (PI-IBS) prevalence, small intestinal bacterial overgrowth (SIBO), altered microbiota, low-grade inflammation, and antibiotic therapy in IBS are all controversial issues.ଝ Please cite this article as: Schmulson M, Bielsa MV, Carmona-Sánchez R, Hernández A, López-Colombo A, Vidal YL, et al. Microbiota, infecciones gastrointestinales, inflamación de bajo grado y antibioticoterapia en el síndrome de intestino irritable. Una revisión basada en evidencias. Revista de Gastroenterología de México. 2014;79:96---134. Aims: To conduct an evidence-based review of these factors. Methods: A review of the literature was carried out up to July 2012, with the inclusion of additional articles as far as August 2013, all of which were analyzed through the Oxford Centre for Evidence-Based Medicine (OCEBM) system. Results: 1. There is greater SIBO probability in IBS when breath tests are performed, but prevalence varies widely (2-84%). 2. The gut microbiota in individuals with IBS is different from that in healthy subjects, but a common characteristic present in all the patients has not been established. 3. The incidence and prevalence of PI-IBS varies from 9-10% and 3-17%, respectively, and the latter decreases over time. Bacterial etiology is the most frequent but post-viral and parasitic cases have been reported. 4. A sub-group of patients has increased enterochromaffin cells, intraepithelial lymphocytes, and mast cells in the intestinal mucosa, but no differences between PI-IBS and non PI-IBS have been determined. 5. Methanogenic microbiota has been associated with IBS with constipation. 6. Rifaximin at doses of 400 mg TID/10 days or 550 mg TID/14 days is an effective treatment for the majority of overall symptoms and abdominal bloating in IBS. Retreatment effectiveness appears to be similar to that of the first cycle.Conclusions: Further studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non PI-IBS. Rifaximin has shown itself to be an effective treatment for IBS, regardless of prior factors. Síndrome de intestino irritable; Sobrepoblación bacteriana; Postinfeccioso; Microbiota; Inflamación de bajo grado; Tratamiento con antibióticos; Rifaximina; Adultos; Niños; Revisión sistemática basada en evidencias
Microbiota, infecciones gastrointestinales, inflamación de bajo grado y antibioticoterapia en el síndrome de intestino irritable. Una revisión basada en evidencias ResumenAntecedentes: Existen controversias sobre la prevalencia del síndrome de intestino irritable (SII)-postinfeccioso (PI), sobrepoblación bacteriana (SPB), alteraciones en la microbiota, inflamación de bajo grado y antibioticoterapia en SII. Objetivos: Realizar una revisión basada en evidencia de estos factores. Métodos: Se realizó una revisión de la literatura hasta julio del 2012 y se incluyeron artículos adicionales hasta agosto del 2013, los cuales fueron analizados mediante el sistema del Centro para Medicina Basada en ...