Small intestinal bacterial overgrowth syndrome

查看全文 作　　者：Jan [1]Bures;Jiri [1]Cyrany;Darina [1]Kohoutova;Miroslav F[2]rstl;Stanislav [1]Rejchrt;Jaroslav [3]Kvetina;Viktor [4]Vorisek;Marcela [1]Kopacova 机构地区：[1]2nd Department of Medicine, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital;[2]Institute of Clinical Microbiology, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital;[3]Institute of Experimental Biopharmaceutics, Joint Research Centre of Czech Academy of Sciences and PRO.MED.CS Praha a.s.;[4]Institute of Clinical Biochemistry and Diagnostics, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital 出　　处：《World Journal of Gastroenterology》索引2010年第16卷第24期,共13页 基　　金：Supported by The Research Project MZO 00179906 from the Ministry of Health, Czech Republic;by Research Grant GACR 305/08/0535, Czech Republic 摘　　要：Human intestinal microbiota create a complex polymi-crobial ecology. This is characterised by its high population density, wide diversity and complexity of interaction. Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequence for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO).SIBO is defined as an increase in the number and/or alteration in the type of bacteria in the upper gastro-intestinal tract. There are several endogenous defence mechanisms for preventing bacterial overgrowth: gastric acid secretion, intestinal motility, intact ileo-caecal valve, immunoglobulins within intestinal secretion and bacte-riostatic properties of pancreatic and biliary secretion. Aetiology of SIBO is usually complex, associated with disorders of protective antibacterial mechanisms (e.g. achlorhydria, pancreatic exocrine insuff iciency, immuno-deficiency syndromes), anatomical abnormalities (e.g. small intestinal obstruction, diverticula, f istulae, surgical blind loop, previous ileo-caecal resections) and/or motility disorders (e.g. scleroderma, autonomic neuropathy in diabetes mellitus, post-radiation enteropathy, small intestinal pseudo-obstruction). In some patients more than one factor may be involved. Symptoms related to SIBO are bloating, diarrhoea, malabsorption, weight loss and malnutrition. The gold standard for diagnosing SIBO is still microbial investigation of jejunal aspirates. Noninvasive hydrogen and methane breath tests are most commonly used for the diagnosis of SIBO using glucose or lactulose. Therapy for SIBO must be com-plex, addressing all causes, symptoms and complica-tions, and fully individualised. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO. 关 键 词：Bacterial overgrowth Breath test HYDROGEN METHANE Small intestine