Small bowel bacterial overgrowth: Difference between revisions

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imported>Robert Badgett
imported>Robert Badgett
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<ref name="pmid15316000">{{cite journal |author=Lin HC |title=Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome |journal=JAMA |volume=292 |issue=7 |pages=852–8 |year=2004 |pmid=15316000 |doi=10.1001/jama.292.7.852}}</ref> Between 10% and 80% of patients with [[irritable bowel syndrome]] have bacterial overgrowth as detected by the lactulose H<sub>2</sub> breath test.<ref name="pmid17043344"/> However, the accuracy of the lactulose H<sub>2</sub> breath test is disputed.<ref name="pmid17043344"/>
<ref name="pmid15316000">{{cite journal |author=Lin HC |title=Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome |journal=JAMA |volume=292 |issue=7 |pages=852–8 |year=2004 |pmid=15316000 |doi=10.1001/jama.292.7.852}}</ref> Between 10% and 80% of patients with [[irritable bowel syndrome]] have bacterial overgrowth as detected by the lactulose H<sub>2</sub> breath test.<ref name="pmid17043344"/> However, the accuracy of the lactulose H<sub>2</sub> breath test is disputed.<ref name="pmid17043344"/>


The intestine is colonised with bacteria (also termed the [[gut flora]]). In studies from the one research group found that 78% to 84% of patients with IBS had [[bacterial overgrowth]].  In patients with evidence of bacterial overgrowth, those treated with [[neomycin]] had a >/= 35% reduction in clinical response (ie, improvement) compared with an 11% reduction in patients on placebo.<ref name="AmJGastro2000-Pimentel">{{cite journal | author=Pimentel M, Chow EJ, Lin HC | title=Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome | journal=Am J Gastroenterol | year=2000 | pages=3503–6 | volume=95 | issue=12 | id=PMID 11151884}}</ref><ref name="AmJGastro2003-Pimentel"> {{cite journal | author=Pimentel M, Chow EJ, Lin HC | title=Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study | journal=Am J Gastroenterol | year=2003 | pages=412–9 | volume=98 | issue=2 | id=PMID 12591062}}</ref>
The intestine is colonised with bacteria (also termed the gut flora). In studies from the one research group found that 78% to 84% of patients with IBS had bacterial overgrowth.  In patients with evidence of bacterial overgrowth, those treated with [[neomycin]] had a >/= 35% reduction in clinical response (ie, improvement) compared with an 11% reduction in patients on placebo.<ref name="AmJGastro2000-Pimentel">{{cite journal | author=Pimentel M, Chow EJ, Lin HC | title=Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome | journal=Am J Gastroenterol | year=2000 | pages=3503–6 | volume=95 | issue=12 | id=PMID 11151884}}</ref><ref name="AmJGastro2003-Pimentel"> {{cite journal | author=Pimentel M, Chow EJ, Lin HC | title=Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study | journal=Am J Gastroenterol | year=2003 | pages=412–9 | volume=98 | issue=2 | id=PMID 12591062}}</ref>


[[Rifaximin]], a nonabsorbed oral [[antibiotic]] improved some symptoms in a randomized controlled trial of patients with [[irritable bowel syndrome]].<ref name="pmid17043337">{{cite journal |author=Pimentel M, Park S, Mirocha J, Kane SV, Kong Y |title=The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial |journal=Ann. Intern. Med. |volume=145 |issue=8 |pages=557–63 |year=2006 |pmid=17043337 |doi=|url=http://www.annals.org/cgi/content/full/145/8/557}}</ref>
[[Rifaximin]], a nonabsorbed oral [[antibiotic]] improved some symptoms in a randomized controlled trial of patients with [[irritable bowel syndrome]].<ref name="pmid17043337">{{cite journal |author=Pimentel M, Park S, Mirocha J, Kane SV, Kong Y |title=The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial |journal=Ann. Intern. Med. |volume=145 |issue=8 |pages=557–63 |year=2006 |pmid=17043337 |doi=|url=http://www.annals.org/cgi/content/full/145/8/557}}</ref>

Revision as of 16:58, 4 January 2008

Small bowel bacterial overgrowth is a syndrome of lower gastrointestinal symptoms that occurs in the settings such as gastrointestinal anatomic abnormalities (such as surgically created blind loops) or abnormal small intestinal motility (diabetic neuropathy).[1]

Small bowel bacterial overgrowth and Irritable bowel syndrome

More controversial is the connection between bacterial overgrowth and irritable bowel syndrome.[2] [3] Between 10% and 80% of patients with irritable bowel syndrome have bacterial overgrowth as detected by the lactulose H2 breath test.[2] However, the accuracy of the lactulose H2 breath test is disputed.[2]

The intestine is colonised with bacteria (also termed the gut flora). In studies from the one research group found that 78% to 84% of patients with IBS had bacterial overgrowth. In patients with evidence of bacterial overgrowth, those treated with neomycin had a >/= 35% reduction in clinical response (ie, improvement) compared with an 11% reduction in patients on placebo.[4][5]

Rifaximin, a nonabsorbed oral antibiotic improved some symptoms in a randomized controlled trial of patients with irritable bowel syndrome.[6]

References

  1. MedlinePlus Medical Encyclopedia: Small bowel bacterial overgrowth. Retrieved on 2008-01-04.
  2. 2.0 2.1 2.2 Drossman DA (2006). "Treatment for bacterial overgrowth in the irritable bowel syndrome". Ann. Intern. Med. 145 (8): 626–8. PMID 17043344[e]
  3. Lin HC (2004). "Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome". JAMA 292 (7): 852–8. DOI:10.1001/jama.292.7.852. PMID 15316000. Research Blogging.
  4. Pimentel M, Chow EJ, Lin HC (2000). "Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome". Am J Gastroenterol 95 (12): 3503–6. PMID 11151884.
  5. Pimentel M, Chow EJ, Lin HC (2003). "Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study". Am J Gastroenterol 98 (2): 412–9. PMID 12591062.
  6. Pimentel M, Park S, Mirocha J, Kane SV, Kong Y (2006). "The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial". Ann. Intern. Med. 145 (8): 557–63. PMID 17043337[e]