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Exploring small intestinal bacterial overgrowth in functional upper gastrointestinal disorder: A comprehensive
Bhaswati C Acharyya1,2, Meghdeep Mukhopadhyay1
1Department of Pediatric Gastroenterology and Hepatology, Institute of Child Health, Kolkata 700017, West Bengal, India.
World Journal of Clinical Pediatrics
|August 29, 2025
Summary
Small intestinal bacterial overgrowth (SIBO) is common in children with unexplained upper GI symptoms. Investigating SIBO in these pediatric patients is recommended, even with normal endoscopic findings.
Area of Science:
- Pediatric Gastroenterology
- Microbiome Research
- Diagnostic Accuracy
Background:
- Small intestinal bacterial overgrowth (SIBO) is frequently suspected in functional gastrointestinal disorders.
- Children with upper GI symptoms are often not tested for SIBO.
Purpose of the Study:
- To determine the prevalence of SIBO in children with functional upper GI symptoms.
- To compare SIBO status in children with and without endoscopic lesions.
Main Methods:
- 129 children (6-18 years) with upper GI symptoms underwent endoscopy before proton pump inhibitors (PPIs).
- Cases had normal endoscopy; controls had endoscopic lesions.
- Glucose-hydrogen breath tests diagnosed SIBO in both groups.
Main Results:
- SIBO was diagnosed in 59% of children with normal endoscopy (cases) versus 21% with lesions (controls).
- The odds ratio for SIBO in cases was 5.38, indicating a significant association.
- Nausea, halitosis, and epigastric fullness predicted SIBO in children.
Conclusions:
- SIBO investigation is valuable for children with upper GI symptoms unexplained by endoscopy.
- Early SIBO diagnosis and treatment can improve pediatric GI health outcomes.
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