Related Experiment Video
Updated: Jul 30, 2025
Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
Published on: February 17, 2023
Small Intestinal Bacterial Overgrowth in Children: Clinical Features and Treatment Response
Maria Isabel Peinado Fabregat1, Rebecca M Gardner2, Maheen A Hassan3
1From the Department of Pediatrics, Division of General Pediatrics at Stanford University, Stanford, CA.
Insights
Pediatric small intestinal bacterial overgrowth (SIBO) treatment showed 72% symptom relief. Antibiotics and probiotics were similarly effective, with no significant difference between metronidazole and rifaximin for treating SIBO in children.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Clinical Research
Background:
- Small intestinal bacterial overgrowth (SIBO) is increasingly diagnosed in children.
- Characterizing the pediatric SIBO population and treatment efficacy is crucial for improving patient outcomes.
Purpose of the Study:
- To characterize the pediatric SIBO population diagnosed via breath test (BT).
- To correlate symptomatology with SIBO diagnosis.
- To describe SIBO treatments and evaluate their efficacy in children.
Main Methods:
- Retrospective cohort study of pediatric patients with positive BT (2012-2018).
- Positive BT defined by specific hydrogen or methane levels.
- Symptom resolution was the primary outcome measure.
Main Results:
- 54 pediatric patients met inclusion criteria; 53.7% were female.
- Symptom resolution achieved in 81.2% with probiotics +/- antibiotics vs. 67.7% with antibiotics alone (P=0.524).
- No significant difference in symptom resolution between metronidazole, rifaximin, or other antibiotics (P=0.601).
Conclusions:
- 72% of pediatric patients experienced symptom relief after SIBO treatment.
- No strong correlation found between specific symptoms and analyte elevation.
- Further research is needed to establish optimal pediatric SIBO treatment strategies.
Abstract:
To characterize the population of children diagnosed with small intestinal bacterial overgrowth (SIBO) based on breath test (BT), correlate symptomatology, and describe SIBO treatments and treatment efficacy.
Methods:
A retrospective cohort study of pediatric patients seen at Stanford Children's Health Gastroenterology Clinics from 2012 to 2018 who had a positive BT, defined by a rise in hydrogen by ≥20 ppm, a baseline hydrogen level ≥20 ppm, or a methane value ≥10 ppm. The main outcome was symptom resolution, defined as complete or partial improvement after a course of treatment. Absolute standardized differences and Chi-square tests were used to assess associations.
Results:
From 98 children, 54 met inclusion and did not meet exclusion criteria (53.7% female). Lactulose substrate was used for 41 (75.9%) patients, whereas glucose was used for 13 (24.1%). Complete or partial resolution of symptoms was achieved in 13 of 16 (81.2%) patients who received probiotics with or without antibiotics versus 21 of 31 (67.7%) patients treated with antibiotics alone (P = 0.524). Metronidazole versus rifaximin versus other antibiotics showed no significant difference in symptom resolution (12 (63.2%), 13 (76.5%), 7 (77.8%), respectively, P = 0.601).
Conclusion:
Seventy-two percent of patients experienced at least partial symptom relief after treatment. We did not find a strong correlation between specific symptoms and analyte elevation. There was no difference in effectiveness between metronidazole and rifaximin to treat SIBO symptoms. Further research needs to be done to determine effective treatments for SIBO in pediatrics.
More Related Videos
Related Concept Videos
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Irritable Bowel Syndrome III: Medical and Nursing Management
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...