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Small intestinal bacterial overgrowth in patients with irritable bowel syndrome.
Gut. 2007 Jun; 56(6):802-8.Gut

Abstract

BACKGROUND

Small intestinal bacterial overgrowth (SIBO) has been proposed to be common in irritable bowel syndrome (IBS), with altered small-bowel motility as a possible predisposing factor.

AIM

To assess the prevalence of SIBO, by culture of small-bowel aspirate, and its correlation to symptoms and motility in IBS.

METHODS

162 patients with IBS who underwent small-bowel manometry and culture of jejunal aspirate were included. Cultures from 26 healthy subjects served as controls. Two definitions of altered flora were used: the standard definition of SIBO (>/=10(5) colonic bacteria/ml), and mildly increased counts of small-bowel bacteria (>/=95th centile in controls).

RESULTS

SIBO (as per standard definition) was found in 4% of both patients and controls. Signs of enteric dysmotility were seen in 86% of patients with SIBO and in 39% of patients without SIBO (p = 0.02). Patients with SIBO had fewer phase III activities (activity fronts) than patients without SIBO (p = 0.08), but otherwise no differences in motility parameters were seen. Mildly increased bacterial counts (>/=5x10(3)/ml) were more common in patients with IBS than in controls (43% vs 12%; p = 0.002), but this was unrelated to small intestinal motility. No correlation between bacterial alterations and symptom pattern was observed.

CONCLUSIONS

The data do not support an important role for SIBO according to commonly used clinical definitions, in IBS. However, mildly increased counts of small-bowel bacteria seem to be more common in IBS, and needs further investigation. Motility alterations could not reliably predict altered small-bowel bacterial flora.

Authors+Show Affiliations

Department of Internal Medicine, Sahlgrenska University Hospital, 41345 Göteborg, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17148502

Citation

Posserud, Iris, et al. "Small Intestinal Bacterial Overgrowth in Patients With Irritable Bowel Syndrome." Gut, vol. 56, no. 6, 2007, pp. 802-8.
Posserud I, Stotzer PO, Björnsson ES, et al. Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut. 2007;56(6):802-8.
Posserud, I., Stotzer, P. O., Björnsson, E. S., Abrahamsson, H., & Simrén, M. (2007). Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut, 56(6), 802-8.
Posserud I, et al. Small Intestinal Bacterial Overgrowth in Patients With Irritable Bowel Syndrome. Gut. 2007;56(6):802-8. PubMed PMID: 17148502.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. AU - Posserud,Iris, AU - Stotzer,Per-Ove, AU - Björnsson,Einar S, AU - Abrahamsson,Hasse, AU - Simrén,Magnus, Y1 - 2006/12/05/ PY - 2006/12/7/pubmed PY - 2007/6/27/medline PY - 2006/12/7/entrez SP - 802 EP - 8 JF - Gut JO - Gut VL - 56 IS - 6 N2 - BACKGROUND: Small intestinal bacterial overgrowth (SIBO) has been proposed to be common in irritable bowel syndrome (IBS), with altered small-bowel motility as a possible predisposing factor. AIM: To assess the prevalence of SIBO, by culture of small-bowel aspirate, and its correlation to symptoms and motility in IBS. METHODS: 162 patients with IBS who underwent small-bowel manometry and culture of jejunal aspirate were included. Cultures from 26 healthy subjects served as controls. Two definitions of altered flora were used: the standard definition of SIBO (>/=10(5) colonic bacteria/ml), and mildly increased counts of small-bowel bacteria (>/=95th centile in controls). RESULTS: SIBO (as per standard definition) was found in 4% of both patients and controls. Signs of enteric dysmotility were seen in 86% of patients with SIBO and in 39% of patients without SIBO (p = 0.02). Patients with SIBO had fewer phase III activities (activity fronts) than patients without SIBO (p = 0.08), but otherwise no differences in motility parameters were seen. Mildly increased bacterial counts (>/=5x10(3)/ml) were more common in patients with IBS than in controls (43% vs 12%; p = 0.002), but this was unrelated to small intestinal motility. No correlation between bacterial alterations and symptom pattern was observed. CONCLUSIONS: The data do not support an important role for SIBO according to commonly used clinical definitions, in IBS. However, mildly increased counts of small-bowel bacteria seem to be more common in IBS, and needs further investigation. Motility alterations could not reliably predict altered small-bowel bacterial flora. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/17148502/Small_intestinal_bacterial_overgrowth_in_patients_with_irritable_bowel_syndrome_ L2 - https://gut.bmj.com/lookup/pmidlookup?view=long&pmid=17148502 DB - PRIME DP - Unbound Medicine ER -