Gut 2008;57:1315-1321
Recent advances in clinical practice
The small intestinal bacterial overgrowth. Irritable bowel syndrome hypothesis: implications for treatment
Dr S Vanner, 166 Brock Streeet, Hotel Dieu Hospital, Kingston, Ontario, Canada K7L 5G2; vanners@hdh.kari.net
Revised version received 2 January 2008
Accepted 17 January 2008
| The first 150 words of the full text of this article appear below. |
Traditionally, small intestinal bacterial overgrowth (SIBO) has been characterised by symptoms of diarrhoea, bloating and sometimes signs of malabsorption. It has been defined as >105 colony-forming units (cfu)/ml of bacteria in aspirates obtained from the small intestine.1 This condition has typically been diagnosed in patients with readily identifiable alterations in small bowel function which predispose patients to SIBO (eg, resected ileocaecal valve, small intestinal hypomotility and possibly hypochlorhydria). Recently, however, this clinical paradigm has been challenged by new theories about the aetiology of irritable bowel syndrome (IBS) and has led to renewed scrutiny of the tests employed to diagnose this condition and controversy concerning the use of antibiotics to treat IBS for suspected SIBO.
The proposal that SIBO accounts for the symptoms of IBS2 3 is a novel and interesting hypothesis, given the rapidly growing evidence that luminal bacteria have previously unrecognised actions on multiple intestinal functions.4 While it has long
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Quigley, E. M.M.
(2009). Review: Do patients with functional gastrointestinal disorders have an altered gut flora?. Therapeutic Advances in Gastroenterology
2: s23-s30
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