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Small Bowel Bacterial Overgrowth in Children
Agnieszka Sieczkowska1, Piotr Landowski, Barbara Kamińska
1*Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdańsk, Gdańsk, Poland†Section of Pediatric Gastroenterology, Hepatology and Transplantation, Hospital Italiano, Buenos Aires, Argentina.
Insights
Small bowel bacterial overgrowth (SBBO) affects children with various conditions, often underdiagnosed. Current diagnostic and treatment strategies for pediatric SBBO lack established guidelines and require further research.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Internal Medicine
Background:
- Small bowel bacterial overgrowth (SBBO) is associated with conditions disrupting normal gut homeostasis in children.
- It can stem from anatomical abnormalities, altered motility, immunodeficiency, or other chronic disorders.
- SBBO may be an underrecognized contributor to pediatric morbidity.
Purpose of the Study:
- To review the pathogenesis, diagnosis, prevalence, manifestations, consequences, and treatment of SBBO in pediatric populations.
- To highlight the current challenges in diagnosing and managing pediatric SBBO.
- To identify the need for further research and guideline development.
Main Methods:
- A comprehensive literature search was conducted.
- Databases searched included MEDLINE, PubMed, and Web of Science.
Main Results:
- SBBO occurs in children with disturbed small bowel homeostasis due to various underlying conditions.
- Existing diagnostic tests for pediatric SBBO have limitations, with no established gold standard.
- Treatment for pediatric SBBO is largely empirical, involving antibiotics or probiotics, due to a lack of interventional studies and guidelines.
Conclusions:
- Further research is essential to elucidate the clinical impact of SBBO in children.
- There is a critical need to establish standardized diagnostic criteria and therapeutic guidelines for pediatric SBBO.
Objectives:
The aim of study was to perform a comprehensive review of the pathogenesis, available diagnostic procedures, prevalence, clinical manifestations, and consequences of small bowel bacterial overgrowth (SBBO) as well as treatment options in the pediatric population.
Methods:
A literature search including MEDLINE, PubMed, and Web of Science databases was performed.
Results:
SBBO is found in a variety of childhood conditions in which the normal homeostatic mechanisms restricting bacterial colonization in the small bowel are disturbed by congenital or acquired anatomical abnormalities, diminished gastric acid secretion, congenital alteration of intestinal motility or acquired small bowel diseases, or other chronic disorders including primary or acquired immunodeficiency. Data show that SBBO may be an underrecognized cause of pediatric morbidity. Although several diagnostic tests for SBBO determination are available, each has its drawbacks and limitations. Indeed, there is still no "criterion standard" for SBBO diagnosis in the pediatric population. Owing to lack of established guidelines and few published interventional studies that assess the effectiveness of SBBO therapy, treatment of children with SBBO remains empiric and comprises antibiotic or probiotic therapy.
Conclusions:
Further research is needed to determine the clinical impact of SBBO and to establish diagnostic and therapeutic guidelines applicable to children.
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