The Impact of Small Intestinal Bacterial Overgrowth on the Growth of Children and Adolescents

Abstract

Objective: To evaluate the association between small intestinal bacterial overgrowth (SIBO) and weight and height impairment in children and adolescents with gastroenterology diseases. Methods: Observational and retrospective study. All 162 patients aged less than 19 years old who underwent breath test in search of SIBO between 2011 and 2016 were studied. Breath test was collected after the intake of 10 grams of lactulose. The concentration of hydrogen and methane was measured for 180 minutes after the beginning of the test by 12i QuinTronMicroLyzer device. Results: SIBO was identified in 51 (31.5%) patients. There was no difference between the age of those with (mean=8.7y.o; 25th and 75th percentile: 4.6 and 11.3) and without (mean=7.9y.o 25th and 75th percentile: 4.8 and 12.2) SIBO (p=0.910). There was no association between gender and SIBO (male 26.3% vs. female 36.3%, p=1.00). A lower median of height-for-age Z score (mean=-1.32; 25th and 75th percentile: -2.12 and -0.08 vs. mean=-0.59; 25th and 75th percentile: -1.57 and 0.22; p=0.04) was demonstrated in children with SIBO when compared with children without it. There was no difference between the BMI-for-age Z score of patients with (mean=-0.48) and without SIBO (mean=-0.06) (p=0.106). The BMI of patients with SIBO (median=15.39) was lower than of those without it (median=16.06); however, the statistical analysis was not significant (p=0.052). The weight-for-age Z score was lower in patients with SIBO (mean=-0.96) than in those without SIBO (mean=-0.22) (p=0.02) Conclusions: Children and adolescents with SBIO associated with diseases of the gastrointestinal tract have lower weight and height values.

Intestinal permeability and small intestine bacterial overgrowth in excess weight adolescents

“…Additionally, SIBO may be accompanied by a decrease in the absorptive surface 41,42 . Similar to the findings observed in our study, these abnormalities generally cause discrete nutritional deficits, revealing differences in the Z‐score values between the two groups 39‐41 . Environmental enteric dysfunction (environmental or tropical enteropathy) is a structural and functional intestinal disorder that results from environmental factors and may cause, among other consequences, changes in the weight and growth of children living in unfavourable sanitary conditions 43,44 .…”

“…In addition, we showed a difference in the mean height/age and BMI/age score Z ( P < .05) of approximately 0.5 and 0.7 SD, respectively, between adolescents with and without SIBO. This relationship was recently found in a study conducted by our group in children with SIBO with associated gastrointestinal tract diseases 39 and in children living in slums 40 . Previous data have shown lower linear growth in children with SIBO than in children without SIBO who were followed from birth to 2 years of age.…”

Influence of Body Composition and Specific Anthropometric Parameters on SIBO Type

“…Additionally, microorganisms compete with the host for micronutrients and macronutrients, causing a lower nutritional status [ 24 , 25 ]. In SIBO patients under the age of 19 years, lower height and body weight were observed based on the height/weight-for-age Z score [ 26 ]. Conversely, there have been multiple associations between SIBO and obesity, with the risk of SIBO being up to two times higher in obese patients compared to individuals with a normal BMI [ 27 ].…”

Diarrhea, Dysbiosis, Dysfunction, and the Disastrous Global Health Consequences: Piecing the Puzzle Together

“…Previous research has demonstrated that dysbiosis in the form of small intestinal bacterial overgrowth (SIBO) is common among children in low-income countries (2) and that SIBO has been associated with growth stunting in nonprospective studies (e.g., cross-sectional studies) (3). Furthermore, although animal models have been developed to describe the mechanism of gastrointestinal infection leading to SIBO (4,5), corroborative human data are lacking.…”