Glucose breath test and Crohn’s disease: Diagnosis of small intestinal bacterial overgrowth and evaluation of therapeutic response

Abstract

SIBO is a frequent but underestimated condition in CD, which often mimics acute flare, effectively identified with GBT and could be treated with a combined antibiotic and probiotic therapy.

Systematic review with meta‐analysis: the prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease

“…Fifteen articles were excluded as ineligible leaving eleven appropriate studies (Figure ). Ten of these studies included patients with CD, four included patients with UC, while three included both UC and CD patients (two case‐control studies and one cohort study). None of the studies included patients with unclassified IBD.…”

“…None of the studies included patients with unclassified IBD. Five of the eleven studies were case control studies and the remaining six were cohort studies . All case‐control studies included healthy volunteers in the non‐IBD control group; however, one study included patients undergoing evaluation of unexplained GI symptoms as a control group.…”

“…Antibiotic treatment of SIBO targets dysbiosis and potentially improves symptoms and other consequences of the altered mucosal or luminal bacterial colonisation. However, there are only a few studies in the literature reporting the efficacy of antibiotic treatment of bacterial overgrowth complicating IBD …”

Negative Effects on Psychological Health and Quality of Life of Genuine Irritable Bowel Syndrome–type Symptoms in Patients With Inflammatory Bowel Disease

“…Furthermore, one-in-three CD patients had undergone intestinal resection previously and, given that bile acid diarrhea or small intestinal bacterial overgrowth may occur as a result of surgery, 10,11 and that there is overlap between the symptoms of these conditions and those of IBS, 12,13 it is possible that we have overestimated the prevalence of IBS. In addition, gold-standard investigations for IBD activity, including small bowel imaging and ileocolonoscopy were not performed routinely as the study was conducted within usual clinical practice.…”

Outcomes of Bariatric Surgery in Patients with Inflammatory Bowel Disease

“…Moreover, nonCrohn's-related gastrointestinal surgery and the intentional malabsorptive state achieved by some bariatric procedures such as RYGB and duodenal switch may negatively influence IBD patients especially those with known CD [12,13]. Intestinal bacterial overgrowth that can develop as a consequence of diversionary bariatric procedures may be associated with acute CD flare-ups [24][25][26]. In addition, there is a potential risk of flare-up in patients with small bowel CD in the operated segment of small bowel after gastric bypass, with an increased risk of stricture, abscesses, and fistulas.…”