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Bacterial concepts in irritable bowel syndrome.
Rev Gastroenterol Disord. 2005; 5 Suppl 3:S3-9.RG

Abstract

An overlap of symptoms in irritable bowel syndrome (IBS) exists across subtype groups. Symptoms include intestinal gas, diarrhea, dyspepsia, bloating, abdominal pain, and constipation. The unifying symptom may be excessive intestinal gas as a by-product of intestinal microbial fermentation. Abnormal fermentation of food takes place when gut microbes expand proximally into the small intestine instead of being confined predominantly to the colon. Such proximal expansion of indigenous gut microbes or small intestinal bacterial overgrowth (SIBO) may lead to activation of host mucosal immunity and an increase in intestinal permeability to result in flu-like extra-intestinal symptoms that accompany the classic IBS symptoms of altered bowels. The presence of methane on lactulose breath testing is associated with constipation-predominant IBS. Antibiotic therapy may be appropriate to treat underlying SIBO in IBS patients. Seventy-five percent improvement of IBS symptoms was reported in a double-blind, placebo-controlled study once antibiotics succeeded in treating bacterial overgrowth. Once a good clinical response and normalization of the lactulose breath test are achieved, a prokinetic agent may be used to stimulate phase III of interdigestive motility to delay relapse of bacterial overgrowth.

Authors+Show Affiliations

Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17713456

Citation

Lin, Henry C., and Mark Pimentel. "Bacterial Concepts in Irritable Bowel Syndrome." Reviews in Gastroenterological Disorders, vol. 5 Suppl 3, 2005, pp. S3-9.
Lin HC, Pimentel M. Bacterial concepts in irritable bowel syndrome. Rev Gastroenterol Disord. 2005;5 Suppl 3:S3-9.
Lin, H. C., & Pimentel, M. (2005). Bacterial concepts in irritable bowel syndrome. Reviews in Gastroenterological Disorders, 5 Suppl 3, S3-9.
Lin HC, Pimentel M. Bacterial Concepts in Irritable Bowel Syndrome. Rev Gastroenterol Disord. 2005;5 Suppl 3:S3-9. PubMed PMID: 17713456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bacterial concepts in irritable bowel syndrome. AU - Lin,Henry C, AU - Pimentel,Mark, PY - 2007/8/24/pubmed PY - 2008/5/30/medline PY - 2007/8/24/entrez SP - S3 EP - 9 JF - Reviews in gastroenterological disorders JO - Rev Gastroenterol Disord VL - 5 Suppl 3 N2 - An overlap of symptoms in irritable bowel syndrome (IBS) exists across subtype groups. Symptoms include intestinal gas, diarrhea, dyspepsia, bloating, abdominal pain, and constipation. The unifying symptom may be excessive intestinal gas as a by-product of intestinal microbial fermentation. Abnormal fermentation of food takes place when gut microbes expand proximally into the small intestine instead of being confined predominantly to the colon. Such proximal expansion of indigenous gut microbes or small intestinal bacterial overgrowth (SIBO) may lead to activation of host mucosal immunity and an increase in intestinal permeability to result in flu-like extra-intestinal symptoms that accompany the classic IBS symptoms of altered bowels. The presence of methane on lactulose breath testing is associated with constipation-predominant IBS. Antibiotic therapy may be appropriate to treat underlying SIBO in IBS patients. Seventy-five percent improvement of IBS symptoms was reported in a double-blind, placebo-controlled study once antibiotics succeeded in treating bacterial overgrowth. Once a good clinical response and normalization of the lactulose breath test are achieved, a prokinetic agent may be used to stimulate phase III of interdigestive motility to delay relapse of bacterial overgrowth. SN - 1533-001X UR - https://www.unboundmedicine.com/medline/citation/17713456/Bacterial_concepts_in_irritable_bowel_syndrome_ L2 - http://www.diseaseinfosearch.org/result/3876 DB - PRIME DP - Unbound Medicine ER -
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