Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review

Nickles, Melissa A; Hasan, Aliza; Shakhbazova, Anastasia; Wright, Sarah; Chambers, Cynthia; Sivamani, Raja K

doi:10.1089/acm.2020.0275

Cited by 23 publications

(24 citation statements)

References 40 publications

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“…However, the excluded children had on average similar characteristics compared with those included children. We included covariates that had been considered appropriate in previous studies such as breastfeeding and antibiotic use [ 20 , 21 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ] to minimize the possible bias [ 50 ] in multivariable analysis. For biomarkers, calprotectin, REG1B, and alpha-1-antitrypsin have been widely used to study typical features of EED [ 34 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

Liu

Fan

Ashorn

et al. 2022

IJERPH

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Environmental enteric dysfunction (EED) is common and contributes to linear growth faltering (stunting) and mortality among children in low-resource settings. A few studies on the environmental causes of EED have been conducted but the exact exposures that cause or predispose children to EED are context-specific and not clear. This study aimed to assess associations between selected environmental exposures and EED markers among 620 18-month-old children. This was a secondary analysis of data from Malawian children who participated in a randomized controlled trial (iLiNS-DYAD, registered at clinicaltrials.gov as NCT01239693) from birth to 18 months of age. Data on environmental exposures, including drinking water source, sanitation, exposure to animals, housing materials, season, residential area, and food insecurity were collected at enrolment. Biomarkers of EED included concentrations of calprotectin, regenerating 1B protein (REG1B), and alpha-1-antitrypsin from stool samples to assess intestinal inflammation, repair, and permeability, respectively. We performed bivariate and multivariable analyses to assess associations between environmental exposures and EED biomarkers. Adjusting for possible confounders, we did not find associations between the selected environmental exposures and the three biomarkers. These results do not provide support for our hypothesis that the studied adverse environmental exposures are associated with increased concentrations of children’s EED markers in rural Malawi.

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Section: Discussionmentioning

confidence: 99%

Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

Liu

Fan

Ashorn

et al. 2022

IJERPH

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“…Despite the ability of probiotics to alter gut microbiota, their efficacy in treatment of SIBO is not encouraging. In a recent meta-analysis [ 203 ], of the five studies on probiotics including 266 patients with SIBO diagnosed using hydrogen breath test (three studies used probiotics only, and two with antibiotics), two studies comparing probiotics and placebo showed a positive result and the other one showed a negative result. Both the studies on probiotics and antibiotics showed that probiotic treatment in addition to antibiotics was superior.…”

Section: Consensus Statementsmentioning

confidence: 99%

Asian-Pacific consensus on small intestinal bacterial overgrowth in gastrointestinal disorders: An initiative of the Indian Neurogastroenterology and Motility Association

Ghoshal

Sachdeva

Ghoshal

et al. 2022

Indian J Gastroenterol

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In the clinical setting, small intestinal bacterial overgrowth (SIBO) is a frequent, but under-diagnosed entity. SIBO is linked to various gastrointestinal (GI) and non-GI disorders with potentially significant morbidity. The optimal management of SIBO is undefined while there is a lack of published consensus guidelines. Against this background, under the auspices of the Indian Neurogastroenterology and Motility Association (INMA), formerly known as the Indian Motility and Functional Diseases Association (IMFDA), experts from the Asian-Pacific region with extensive research and clinical experience in the field of gut dysbiosis including SIBO developed this evidence-based practice guideline for the management of SIBO utilizing a modified Delphi process based upon 37 consensus statements, involving an electronic voting process as well as face-to-face meetings and review of relevant supporting literature. These statements include 6 statements on definition and epidemiology; 11 on etiopathogenesis and pathophysiology; 5 on clinical manifestations, differential diagnosis, and predictors; and 15 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservations was 80% or higher, the statement was regarded as accepted. The members of the consensus team consider that this guideline would be valuable to inform clinical practice, teaching, and research on SIBO in the Asian-Pacific region as well as in other countries.

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“…A recent systematic review included studies that evaluated the use of probiotics, an elemental diet, and herbal therapy for the treatment of SIBO[ 11 ]. It was observed that in randomized clinical trials that evaluated the use of probiotics, there was heterogeneity between the strains used and the duration of treatment, and regarding the methodological quality, most studies were of moderate quality.…”

Section: Diet and Sibo: What Is The Evidencementioning

confidence: 99%

“…Although it may seem effective, an elemental diet is difficult to follow, and the literature lacks further studies for the clinical applicability of these diets. Regarding the use of medicinal herbs, although a few studies showed promising results in relation to the improvement of symptoms, these studies were of low methodological quality, and further studies are needed to standardize and prove the safety for the clinical applicability of these herbs[ 11 ].…”

Section: Diet and Sibo: What Is The Evidencementioning

confidence: 99%

Diet and intestinal bacterial overgrowth: Is there evidence?

Souza¹,

Rocha²,

Cotrim³

2022

WJCC

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The intestinal microbiota and its role in health and disease processes have been the subject of several studies. It is known that changes in the intestinal microbiota occur due to several factors, such as the use of medication, age, lifestyle and diseases, which can modify intestinal homeostasis and lead to excessive growth of bacteria in the small intestine, triggering a clinical condition called small bowel bacterial overgrowth (SIBO). Individuals with SIBO may present gastrointestinal symptoms ranging from nausea, diarrhea and/or constipation, and flatulence to distension and abdominal pain, resulting from poor absorption of nutrients or changes in intestinal permeability. The gold-standard treatment is based on the use of antibiotics to eradicate bacterial overgrowth. Some studies have evaluated diets in the treatment of SIBO; however, the studies are of low methodological quality, making extrapolation of the results to clinical practice unfeasible. Thus, there is still not enough scientific evidence to support a specific type of diet for the treatment of SIBO.

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Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review

Cited by 23 publications

References 40 publications

Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

Asian-Pacific consensus on small intestinal bacterial overgrowth in gastrointestinal disorders: An initiative of the Indian Neurogastroenterology and Motility Association

Diet and intestinal bacterial overgrowth: Is there evidence?

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