Review article: small intestinal bacterial overgrowth - prevalence, clinical features, current and developing diagnostic tests, and treatment

Grace, E. M.; Shaw, Clare; Whelan, Kevin; Andreyev, H. J. N.

doi:10.1111/apt.12456

Cited by 185 publications

(154 citation statements)

References 120 publications

(138 reference statements)

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“…17 Previous studies reported that SIBO is one of the most important causes of FGID including IBS. 18 However, FGID is comprised of complex symptoms and a heterogeneous disorder with a wide spectrum of symptoms including abdominal pain, bloating, flatulence, diarrhea and /or constipation etc. A systematic review and meta-analysis of studies investigating the frequency of SIBO in IBS found that the prevalence of SIBO was between 4% and 64%.…”

Section: Discussionmentioning

confidence: 99%

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

Sung

Paik

Chung

et al. 2015

J Neurogastroenterol Motil

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Background/AimsPatients undergoing cholecystectomy may have small intestinal bacterial overgrowth (SIBO). We investigated the prevalence and characteristics of SIBO in patients with intestinal symptoms following cholecystectomy. MethodsSixty-two patients following cholecystectomy, 145 with functional gastrointestinal diseases (FGIDs), and 30 healthy controls undergoing hydrogen (H2)-methane (CH4) glucose breath test (GBT) were included in the study. Before performing GBT, all patients were interrogated using bowel symptom questionnaire. The positivity to GBT indicating the presence of SIBO, gas types and bowel symptoms were surveyed. ResultsPost-cholecystectomy patients more often had SIBO as evidenced by a positive (+) GBT than those with FGID and controls (29/62, 46.8% vs 38/145, 26.2% vs 4/30, 13.3%, respectively; P = 0.010). In the gas types, the GBT (H2) + post-cholecystectomy patients was significantly higher than those in FGIDs patients (P = 0.017). Especially, positivity to fasting GBT (H2) among the GBT (H2)+ post-cholecystectomy patients was high, as diagnosed by elevated fasting H2 level. The GBT+ group had higher symptom scores of significance or tendency in abdominal discomfort, bloating, chest discomfort, early satiety, nausea, and tenesmus than those of the GBT negative group. The status of cholecystectomy was the only significant independent factor for predicting SIBO. ConclusionsThe SIBO with high levels of baseline H2 might be the important etiologic factor of upper GI symptoms for post-cholecystectomy patients. (J Neurogastroenterol Motil 2015;21:545-551)

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Section: Discussionmentioning

confidence: 99%

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

Sung

Paik

Chung

et al. 2015

J Neurogastroenterol Motil

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“…To be included in our meta-analysis studies had to meet following criteria; (1) RCTs with at least a 12-month follow-up period, (2) study population of patients with dyspepsia (symptom-based Rome I, II, or III classification), (3) symptoms of dyspepsia defined as an outcome measurement of the study, (4) H. pylori infection verified by rapid urease test, 13 C breath test, or histologic examination, (5) treatment group received triple or quadruple therapy for 7-14 days, and (6) control group who only received placebo as intervention and were not treated with any other antibiotics or bismuth.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…[6][7][8][9][10][11][12] Increasing eosinophils of the duodenum secondary to the exposure of gastric acid or food allergens to the duodenum might correlate with FD, and it has been suggested that there is a correlation between eosinophils and low-grade inflammation. 13,14 Furthermore, it has been…”

Section: Introductionmentioning

confidence: 99%

IsHelicobacter pyloriAssociated Functional Dyspepsia Correlated With Dysbiosis?

Kim

Chung

Kim

et al. 2017

J Neurogastroenterol Motil

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Background/AimsTo assess the long-term effect of Helicobacter pylori eradication on symptomatic improvement according to the type of antibiotic and the duration of treatment in H. pylori-associated functional dyspepsia. MethodsWe searched Pubmed, Embase, CINAHL, and the Cochrane library databases for randomized controlled trials written in English and undertaken up to August 2016 that met our eligibility criteria. The search methodology used combinations of the following keywords: Helicobacter pylori OR H. pylori OR HP; dyspepsia OR functional dyspepsia OR non-ulcer dyspepsia; eradication OR cure OR treatment. The study outcome was the summary odds ratio (OR) for symptomatic improvement in H. pylori-associated functional dyspepsia with successful eradication therapy. Subgroup analyses were performed based on the type of antibiotic, and the duration of treatment, whether or not patients had symptoms of irritable bowel syndrome, and on race. ResultsSixteen randomized controlled trials met the inclusion criteria. The summary OR for symptomatic improvement in patients in our eradication group was 1.33 (95% confidence interval [CI], 1.16-1.54; P < 0.01). In a subgroup analysis on type of antibiotic, symptomatic improvement with metronidazole-containing regimen (OR, 1.87; 95% CI, 1.26-2.77) was better than treatment with clarithromycin (OR, 1.29; 95% CI, 1.11-1.50). H. pylori eradication therapy given for 10-14 days was the more effective for symptom improvement than 7-day therapy. When the studies excluding irritable bowel syndrome cases were analyzed, there were no therapeutic effects of H. pylori eradication on symptomatic improvement. ConclusionsIn the clinical setting, the most effective H. pylori eradication regimen for functional dyspepsia to provide relief of symptoms is a metronidazole-based treatment regimen for at least 10 days. The explanation for this is that H. pylori-associated functional dyspepsia could be associated with dysbiosis.

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“…Gravec et al przeprowadzili analizę obja wów u pacjentów mających dodatni wynik testu oddechowego potwierdzający SIBO w zależności od choroby podstawowej. Dominującym objawem były wzdęcia brzucha, które występowały u 59% chorych leczonych inhibitorami pompy protono wej z powodu refluksu, 86% chorych na twardzinę układową oraz 13% chorych skarżących się na ga stroparezę [16]. Do najczęstszych przyczyn przerostu bakte ryjnego zalicza się nieprawidłowości anatomicz ne (zabiegi chirurgiczne, np.…”

Section: Przyczynyunclassified

Abdominal Bloating: Most Frequent Causes and Treatment

Gulbicka¹,

Grzymisławski²

2016

Piel. Zdr. Publ.

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A -koncepcja i projekt badania; B -gromadzenie i/lub zestawianie danych; C -analiza i interpretacja danych; D -napisanie artykułu; E -krytyczne zrecenzowanie artykułu; F -zatwierdzenie ostatecznej wersji artykułu Streszczenie W warunkach fizjologicznych objętość gazów wynosi około 200 ml, z czego 90% stanowi azot, a dzienne oddawanie gazów u ludzi zdrowych odbywa się 14-25 razy na dobę. Gazy jelitowe powstają najczęściej na drodze fermenta cji lub na skutek połykania powietrza. Wzdęcie brzucha jest objawem dość często zgłaszanym przez pacjentów. Szacuje się, że problem ten dotyczy około 16-30% populacji krajów zachodnich i około 30% ludności w Polsce. Najczęściej dochodzi do zaburzeń homeostazy gazów jelitowych. Jednostki chorobowe, którym towarzyszy uczucie wzdęcia to: zespół jelita drażliwego, SIBO (small intestinal bacterial overgrowth), czyli zespół przerostu bakteryjne go jelita cienkiego, nietolerancje pokarmowe, zaparcia, rak jelita grubego i inne. Przystępując do badania pacjenta, trzeba pamiętać, że wywiad lekarski jest źródłem wielu cennych informacji, a w badaniu przedmiotowym należy zwrócić uwagę na objawy alarmowe, takie jak: utrata masy ciała, symetria brzucha, zmiany skórne. Wykonanie badań laboratoryjnych jest ponadto pomocne w ustaleniu przyczyny. Wybierając badania radiologiczne, należy kierować się dostępnością oraz niewielką inwazyjnością badań. Cennym badaniem diagnostycznym są testy odde chowe. Najprostszą metodą leczenia jest zmiana diety, eliminacja pokarmów gazotwórczych, takich jak np. nasiona roślin strączkowych czy glutenu w przypadku celiakii. U niektórych pacjentów wykluczenie z diety FODMAP (Fermentale Oligosacharydes, Disacharydes, Mono and Polyols) również daje dobre rezultaty. Zastosowanie bakterii probiotycznych może być korzystne, ale potrzeba jeszcze dodatkowych badań. W leczeniu są stosowane leki proki netyczne, absorpcyjne oraz zmniejszające napięcie powierzchniowe. W badaniach klinicznych wykazano skutecz ność leków z grupy SSRI. Zmiana stylu życia, aktywność fizyczna i pomoc psychologiczna są ważnymi czynnikami pomagającymi w zmniejszaniu liczby objawów (Piel. Zdr. Publ. 2016, 6, 1, 69-76).Słowa kluczowe: wzdęcia, gazy jelitowe, nietolerancje pokarmowe, zespół jelita drażliwego. AbstractIn physiological conditions, the volume of gases is approximately 200 mL, 90% of which is nitrogen, while the daily excretion of gases in healthy people occurs 14-25 a day. Most intestinal gases are produced by fermentation or as a result of swallowing air. Abdominal distension is a symptom quite commonly described by patients. It is estimated that this problem affects about 16-30% of the population of western countries and approximately 30% of the popul ation in Poland. Disturbances of intestinal gases homeostasis commonly occur. Disease entities accompanied by bloating are irritable bowel syndrome, SIBO (small intestine bacterial overgrowth), food intolerances, constipation, colon cancer and many others. When beginning to evaluate the patient, patient's history becomes a source of valuab...

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Review article: small intestinal bacterial overgrowth - prevalence, clinical features, current and developing diagnostic tests, and treatment

Cited by 185 publications

References 120 publications

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

IsHelicobacter pyloriAssociated Functional Dyspepsia Correlated With Dysbiosis?

Abdominal Bloating: Most Frequent Causes and Treatment

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