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Prevalence of small intestinal bacterial overgrowth in children with irritable bowel syndrome: a case-control study
E Scarpellini1, V Giorgio, M Gabrielli
1Internal Medicine Department, Catholic University of Sacred Heart, Gemelli Hospital, Rome, Italy.
Insights
Small intestinal bacterial overgrowth (SIBO) is significantly more common in children with irritable bowel syndrome (IBS). This finding highlights a potential link between SIBO and childhood IBS, warranting further investigation.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Digestive Health
Background:
- Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder in children.
- Small Intestinal Bacterial Overgrowth (SIBO) is characterized by excessive bacteria in the small intestine.
Purpose of the Study:
- To determine the prevalence of SIBO in pediatric patients diagnosed with IBS.
- To investigate the association between SIBO and IBS symptoms in children.
Main Methods:
- A case-control study involving 43 children with IBS (Rome II criteria) and 56 healthy controls.
- Lactulose/methane breath test (LBT) was used to diagnose SIBO in all participants.
Main Results:
- The prevalence of SIBO was significantly higher in children with IBS (65%) compared to healthy controls (7%).
- A trend towards worse visual analog scale scores and a significant difference in bloating severity were observed in IBS patients with SIBO.
Conclusions:
- This study indicates a significant epidemiological association between SIBO and IBS in the pediatric population.
- Further placebo-controlled trials using antibiotics are recommended to confirm the therapeutic impact of treating bacterial overgrowth on IBS symptoms in children.
Objective:
To assess the prevalence of small intestinal bacterial overgrowth (SIBO) in children affected by irritable bowel syndrome (IBS).
Study Design:
Consecutive children affected by IBS according to Rome II criteria (n = 43) were enrolled at the Gemelli Hospital, Catholic University of Rome. The control population (n = 56) consisted of healthy subjects without IBS symptoms, similar to patients for age, sex, and social background. All subjects underwent lactulose/methane breath test (LBT) to assess small intestinal bacterial overgrowth.
Results:
The prevalence of abnormal LBT result was significantly higher in patients with IBS (65%, 28/43) with respect to control subjects (7%, 4/56; OR 3.9, 95% CI 7.3-80.1, P < .00001). Patients with abnormal LBT showed a trend toward a worse visual analog scale score with respect to children with IBS without SIBO, but a significant statistical difference was observed only for bloating.
Conclusions:
Results from this study suggest a significant epidemiologic association between SIBO and IBS in childhood. Placebo-controlled interventional studies with antibiotics used to treat bacterial overgrowth are warranted to clarify the real impact of the disease on IBS symptoms.
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