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[Microecological aspects of small intestinal bacterial overgrowth syndrome]

V M Bondarenko, E A Lykova, T V Matsulevich

    Zhurnal Mikrobiologii, Epidemiologii I Immunobiologii
    |December 14, 2006
    PubMed

    Insights

    Small intestinal bacterial overgrowth syndrome (SIBOS) involves excessive bacteria in the small intestine, leading to malabsorption and infection risks. Diagnosis uses breath tests or aspirate cultures, with treatment involving probiotics and antibiotics.

    Area of Science:

    • Gastroenterology
    • Microbiology
    • Internal Medicine

    Context:

    • Small intestinal bacterial overgrowth syndrome (SIBOS) is characterized by chronic diarrhea, malabsorption, and increased infection risk.
    • Elevated bacterial counts (>10^5 CFU/ml in adults, >10^4 CFU/ml in children) and diverse microbial species in the small intestine define SIBOS.
    • SIBOS represents a significant disturbance of intestinal microflora, often termed dysbacteriosis.

    Purpose:

    • To define Small Intestinal Bacterial Overgrowth Syndrome (SIBOS) and its associated clinical and microbiological features.
    • To outline diagnostic methods for SIBOS, including hydrogen breath testing and direct small intestine aspirate analysis.
    • To describe the comprehensive treatment strategies for SIBOS, encompassing probiotics and antimicrobial agents.

    Summary:

    • SIBOS presents with malabsorption, intoxication, and heightened risk of endogenous infection due to increased bacterial load in the small intestine.
    • Microecological shifts in SIBOS can lead to B12 deficiency anemia, hypovitaminosis, protein deficiency, bacterial translocation, endotoxinemia, and potential infection generalization.
    • Diagnostic approaches include lactulose breath tests measuring hydrogen concentration and bacteriological examination of small intestinal aspirates.
    • Treatment involves probiotics (Lactobacillus, Bifidobacterium) and, for severe cases, antibiotics such as vancomycin, metronidazole, aminoglycosides, amoxicillin-clavulanate, tetracycline, and second-generation cephalosporins, followed by probiotic restoration.

    Impact:

    • Understanding SIBOS is crucial for managing chronic gastrointestinal disorders characterized by malabsorption and dysbiosis.
    • Accurate diagnosis and targeted treatment of SIBOS can prevent complications like vitamin deficiencies and systemic infections.
    • Effective management of SIBOS, combining antibiotics and probiotics, aims to restore intestinal homeostasis and improve patient outcomes.

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