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Chronic abdominal pain in children is associated with high prevalence of abnormal microbial fermentation

Brynie Slome Collins1, Henry C Lin

  • 1Division of Gastroenterology and Nutrition, Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, 4650 Sunset Blvd. MS #78, Los Angeles, CA 90027, USA. bcollins@chla.usc.edu

Digestive Diseases and Sciences
|November 6, 2009
PubMed

Insights

Small intestinal bacterial overgrowth (SIBO) is highly prevalent in children with chronic abdominal pain (CAP), affecting 91% of cases. This finding suggests SIBO may be a significant factor in pediatric CAP.

Area of Science:

  • Pediatric Gastroenterology
  • Microbiome Research
  • Digestive Health

Background:

  • Chronic abdominal pain (CAP) is common in children, potentially preceding adult irritable bowel syndrome (IBS).
  • Small intestinal bacterial overgrowth (SIBO) is frequently observed in adults with IBS.
  • The prevalence of SIBO in children with CAP has not been well-established.

Purpose of the Study:

  • To determine the prevalence of SIBO in children diagnosed with chronic abdominal pain.
  • To compare SIBO rates in children with CAP to healthy controls.

Main Methods:

  • Seventy-five children (8-18 years) with CAP (Rome II criteria) and 40 healthy controls were enrolled.
  • A lactulose breath hydrogen test (LBT) was used to diagnose SIBO in all participants.
  • Symptom questionnaires were administered to children with CAP.

Main Results:

  • A high prevalence of SIBO (91%) was detected in children with CAP, compared to 35% in controls (OR=16.7, P<0.0001).
  • Children with CAP and SIBO reported increased bowel movement urgency and decreased soiling.
  • No significant differences in pain location or other symptoms were found between SIBO-positive and SIBO-negative CAP groups.

Conclusions:

  • SIBO is significantly more prevalent in children with CAP than in healthy children.
  • Further research, including randomized controlled trials, is warranted to explore SIBO eradication for symptom improvement in pediatric CAP.
Abstract

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