Small intestinal bacterial overgrowth in children: A state-of-the-art review

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Date
2019-09-04
Authors
Avelar Rodriguez, David
Ryan, Paul M.
Toro Monjaraz, Erick Manuel
Ramirez Mayans, Jaime Alfonso
Quigley, Eamonn M.
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Frontiers Media
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Abstract
Small intestinal bacterial overgrowth (SIBO) is a heterogenous and poorly understood entity characterised by an excessive growth of select microorganisms within the small intestine. This excessive bacterial biomass, in turn, disrupts host physiology in a myriad of ways, leading to gastrointestinal and non-gastrointestinal symptoms and complications. SIBO is a common cause of non-specific gastrointestinal symptoms in children, such as chronic abdominal pain, abdominal distention, diarrhoea, and flatulence, amongst others. In addition, it has recently been implicated in the pathophysiology of stunting, a disease that affects millions of children worldwide. Risk factors such as acid-suppressive therapies, alterations in gastrointestinal motility and anatomy, as well as impoverished conditions, have been shown to predispose children to SIBO. SIBO can be diagnosed via culture-dependant or culture-independent approaches. SIBO's epidemiology is limited due to the lack of uniformity and consensus of its diagnostic criteria, as well as the paucity of literature available. Antibiotics remain the first-line treatment option for SIBO, although emerging modalities such as probiotics and diet manipulation could also have a role. Herein, we present a state-of-the-art-review which aims to comprehensively outline the most current information on SIBO in children, with particular emphasis on the gut microbiota.
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Small intestine bacterial overgrowth , Small bowel bacterial overgrowth , Proton pump inhibitors , Gut microbiota , Stunting
Citation
Avelar Rodriguez, D., Ryan, P. M., Toro Monjaraz, E. M., Ramirez Mayans, J. A. and Quigley, E. M. (2019) 'Small Intestinal Bacterial Overgrowth in Children: A State-Of-The-Art Review', Frontiers in Pediatrics, 7, 363 (20pp). DOI: 10.3389/fped.2019.00363