Irritable bowel syndrome and small intestinal bacterial overgrowth:Meaningful association or unnecessary hype

Irritable bowel syndrome(IBS)is a common condition characterized by abdominal pain or discomfort,bloating,and altered stool form and passage.Small intestinal bacterial overgrowth(SIBO)is a condition in which there is overgrowth of bacteria in small bowel in excess of 105colony forming units per mill...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2014-03, Vol.20 (10), p.2482-2491
Main Authors: Ghoshal, Uday C, Srivastava, Deepakshi
Format: Article
Language:English
Subjects:
Animals
Anti-Bacterial Agents - therapeutic use
Bacteria - growth & development
Bacteria - metabolism
breath
Breath Tests
Fermentation
Glucose
Host-Parasite Interactions
Humans
hydrogen
Intestine, Small - metabolism
Intestine, Small - microbiology
Irritable Bowel Syndrome - diagnosis
Irritable Bowel Syndrome - metabolism
Irritable Bowel Syndrome - microbiology
Irritable Bowel Syndrome - therapy
Lactulose
Phenotype
Predictive Value of Tests
Probiotics - therapeutic use
Risk Factors
test
Topic Highlight
Treatment Outcome
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Summary:Irritable bowel syndrome(IBS)is a common condition characterized by abdominal pain or discomfort,bloating,and altered stool form and passage.Small intestinal bacterial overgrowth(SIBO)is a condition in which there is overgrowth of bacteria in small bowel in excess of 105colony forming units per milliliter on culture of the upper gut aspirate.Frequency of SIBO varied from 4%-78%among patients with IBS and from 1%-40%among controls.Higher frequency in some studies might be due to fallacious criteria[postlactulose breath-hydrogen rise 20 PPM above basal within 90 min(early-peak)].Glucose hydrogen breath test(GHBT)has a low sensitivity to diagnose SIBO.Hence,studies based on GHBT might have under-estimated frequency of SIBO.Therefore,it is important to analyze these studies carefully to evaluate whether the reported association between IBS and SIBO is over or under-projected.This review evaluates studies on association between SIBO and IBS,discordance between different studies,their strength and weakness including methodological issues and evidence on therapeutic manipulation of gut flora on symptoms of IBS.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v20.i10.2482