Review article: small intestinal bacterial overgrowth - prevalence, clinical features, current and developing diagnostic tests, and treatment

TY - JOUR

T1 - Review article: small intestinal bacterial overgrowth - prevalence, clinical features, current and developing diagnostic tests, and treatment

AU - Grace, E.

AU - Shaw, C.

AU - Whelan, K.

AU - Andreyev, H. J. N.

PY - 2013/10

Y1 - 2013/10

N2 - BackgroundThe symptoms and signs of small intestinal bacterial overgrowth (SIBO) are often identical to a variety of diseases and can lead to diagnostic confusion.AimsTo review the diagnostic options for SIBO and present new investigative options for the condition.MethodsA literature search was performed on MEDLINE, EMBASE and Web of Science for English articles and abstracts. Search terms included free text words and combinations of the following terms 'small intestinal bacterial overgrowth', 'small bowel bacterial overgrowth', 'diagnostic tests', 'treatment', 'antibiotics', 'probiotics', 'metabonomics', 'proton nuclear magnetic resonance spectroscopy', 'electronic nose' and 'field asymmetric ion mobility spectrometry'.ResultsAll of the available methods to test for SIBO have inherent limitations and no 'gold-standard' diagnostic test for the condition exists. Accurate diagnosis of SIBO requires identification of bacterial species growing inappropriately within the small intestine and symptom response to antibiotics. Proton nuclear magnetic resonance spectroscopy, electronic nose technology and/or field asymmetric ion mobility spectrometry may represent better investigative options for the condition.ConclusionsNovel diagnostic options are needed to supplement or replace available tests.

AB - BackgroundThe symptoms and signs of small intestinal bacterial overgrowth (SIBO) are often identical to a variety of diseases and can lead to diagnostic confusion.AimsTo review the diagnostic options for SIBO and present new investigative options for the condition.MethodsA literature search was performed on MEDLINE, EMBASE and Web of Science for English articles and abstracts. Search terms included free text words and combinations of the following terms 'small intestinal bacterial overgrowth', 'small bowel bacterial overgrowth', 'diagnostic tests', 'treatment', 'antibiotics', 'probiotics', 'metabonomics', 'proton nuclear magnetic resonance spectroscopy', 'electronic nose' and 'field asymmetric ion mobility spectrometry'.ResultsAll of the available methods to test for SIBO have inherent limitations and no 'gold-standard' diagnostic test for the condition exists. Accurate diagnosis of SIBO requires identification of bacterial species growing inappropriately within the small intestine and symptom response to antibiotics. Proton nuclear magnetic resonance spectroscopy, electronic nose technology and/or field asymmetric ion mobility spectrometry may represent better investigative options for the condition.ConclusionsNovel diagnostic options are needed to supplement or replace available tests.

KW - IRRITABLE-BOWEL-SYNDROME

KW - BLIND-LOOP SYNDROME

KW - VOLATILE ORGANIC-COMPOUNDS

KW - UNCONJUGATED BILE-ACIDS

KW - INDIGENOUS GUT FLORA

KW - HYDROGEN BREATH TEST

KW - GASTROINTESTINAL SYMPTOMS

KW - LIVER-CIRRHOSIS

KW - CROHNS-DISEASE

KW - ANTIBIOTIC-TREATMENT

U2 - 10.1111/apt.12456

DO - 10.1111/apt.12456

M3 - Review article

SN - 0269-2813

VL - 38

SP - 674

EP - 688

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

IS - 7

M1 - N/A

ER -