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Small intestinal bacterial overgrowth: could it be associated with chronic abdominal pain in children with allergic
Rubén Peña-Vélez1, Erick Toro-Monjaraz2, David Avelar-Rodríguez2
1Gastroenterología y Nutrición, Instituto Nacional de Pediatría (INP), México.
Insights
Children with chronic abdominal pain (CAP) and allergies are more likely to have small intestinal bacterial overgrowth (SIBO). Ruling out SIBO is recommended for pediatric patients with CAP and allergic disease.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
Background:
- Small intestinal bacterial overgrowth (SIBO) is a common cause of chronic abdominal pain (CAP) in children.
- Children with allergic disorders frequently experience CAP.
- The co-occurrence of allergies and CAP in children warrants further investigation.
Purpose of the Study:
- To investigate the association between allergic diseases and SIBO in pediatric patients diagnosed with CAP.
- To determine if allergic conditions increase the likelihood of SIBO in children with CAP.
Main Methods:
- Observational, analytical, retrospective study design.
- Inclusion of pediatric patients with CAP who underwent lactulose hydrogen breath testing for SIBO diagnosis.
- Allergic evaluation using skin prick tests or specific IgE determination.
Main Results:
- SIBO was diagnosed in 35 out of 70 pediatric patients with CAP.
- A significantly higher prevalence of allergic diseases was observed in children with SIBO (71.4%) compared to those without SIBO (28.6%).
- Patients with SIBO had an odds ratio of 5.45 for having any allergy (p = 0.001).
Conclusions:
- An association exists between small intestinal bacterial overgrowth (SIBO) and allergic diseases, including allergic rhinitis, cow's milk protein allergy, and asthma.
- SIBO should be considered and ruled out in pediatric patients presenting with chronic abdominal pain and a history of allergic disease.
Background And Aims:
small intestinal bacterial overgrowth (SIBO) is a well-known cause of chronic abdominal pain (CAP) during the pediatric age. On the other hand, children with a history of some allergic disorder present CAP more frequently. The aim of this study was to determine the association between the presence of allergic diseases and SIBO in patients diagnosed with CAP.
Materials And Methods:
this was an observational, analytical, retrospective study. Children with CAP who had undergone a lactulose hydrogen breath test to determine the presence of SIBO were included in the study. All patients underwent an evaluation for allergies by means of a skin prick test or the determination of specific IgE, according to clinical diagnosis. The study groups were established according to the presence of SIBO and the results of the allergic evaluation were statistically compared between the groups.
Results:
seventy patients were included (41 females and 29 males) and SIBO was diagnosed in 35 patients. In addition, 71.4% of children with SIBO were found to have an allergic disease, in contrast with 28.6% of children without SIBO (p = 0.001). The odds ratio for having any type of allergy in patients with SIBO was 5.45 (95% CI, 1.96-15.17; p = 0.001).
Conclusions:
we found an association between SIBO and allergic disease, especially allergic rhinitis, cow's milk protein allergy and asthma. Thus, SIBO should be ruled out in pediatric patients with CAP and allergic disease.
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