Small Intestine Bacterial Overgrowth and Environmental Enteropathy in Bangladeshi Children

Abstract

Recent studies suggest small intestine bacterial overgrowth (SIBO) is common among developing world children. SIBO’s pathogenesis and effect in the developing world are unclear. Our objective was to determine the prevalence of SIBO in Bangladeshi children and its association with malnutrition. Secondary objectives included determination of SIBO’s association with sanitation, diarrheal disease, and environmental enteropathy. We performed a cross-sectional analysis of 90 Bangladeshi 2-year-olds monitored since birth from an impoverished neighborhood. SIBO was diagnosed via glucose hydrogen breath testing, with a cutoff of a 12-ppm increase over baseline used for SIBO positivity. Multivariable logistic regression was performed to investigate SIBO predictors. Differences in concomitant inflammation and permeability between SIBO-positive and -negative children were compared with multiple comparison adjustment. A total of 16.7% (15/90) of the children had SIBO. The strongest predictors of SIBO were decreased length-for-age Z score since birth (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.03 to 0.60) and an open sewer outside the home (OR, 4.78; 95% CI, 1.06 to 21.62). Recent or frequent diarrheal disease did not predict SIBO. The markers of intestinal inflammation fecal Reg 1β (116.8 versus 65.6 µg/ml; P = 0.02) and fecal calprotectin (1,834.6 versus 766.7 µg/g; P = 0.004) were elevated in SIBO-positive children. Measures of intestinal permeability and systemic inflammation did not differ between the groups. These findings suggest linear growth faltering and poor sanitation are associated with SIBO independently of recent or frequent diarrheal disease. SIBO is associated with intestinal inflammation but not increased permeability or systemic inflammation.

Modeling human enteric dysbiosis and rotavirus immunity in gnotobiotic pigs

“…Myeloperoxidase is released from activated neutrophils and is an indicator of inflammation [9]. REG1B is a pro proliferative antiapoptotic protein secreted by damaged enterocyte and is involved in tissue repair, cell growth and regeneration [23, 24]. There were no significant differences between the two pig groups at PID28 or PCD7 (Additional file 1: Table S2).…”

Mouthing of Soil Contaminated Objects is Associated with Environmental Enteropathy in Young Children

“…Furthermore, Donowitz et al . reported that recent and frequent diarrhoea episodes were not significant predictors of small intestine bacterial overgrowth (SIBO), a condition in which excessive amounts of bacteria are present in the small intestine, while SIBO was associated with intestinal inflammation and linear growth faltering among Bangladeshi children .…”

“…A study in peri-urban Peru found that while symptomatic cryptosporidiosis had a greater adverse effect on child growth compared to asymptomatic cryptosporidiosis, the latter was twice as prevalent and thus may have had a greater effect on growth faltering [62]. Furthermore, Donowitz et al reported that recent and frequent diarrhoea episodes were not significant predictors of small intestine bacterial overgrowth (SIBO), a condition in which excessive amounts of bacteria are present in the small intestine, while SIBO was associated with intestinal inflammation and linear growth faltering among Bangladeshi children [63]. There are several limitations to this study.…”

Keadaan Mikrobiota Saluran Cerna pada Anak Sekolah Dasar yang Mengalami Stunting di Lombok Barat

“…Pertumbuhan bakteri patogen yang berlebihan pada saluran cerna yang diakibatkan karena infeksi dan imun yang rendah akan menyebabkan probiotik yang ada di saluran cerna menurun. Komposisi bakteri patogen yang banyak menyebabkan inflamasi dan malabsorbsi zat gizi sehingga menyebabkan stunting (Donowitz et al 2016). Penyakit infeksi dan asupan gizi yang buruk mampu menyebabkan environmental enteric dysfunction.…”