Review
Gastroenterology & Hepatology
Arjun Gandhi, Ayesha Shah, Michael P. Jones, Natasha Koloski, Nicholas J. Talley, Mark Morrison, Gerald Holtmann
Summary: The systematic review and meta-analysis indicated that methane-positive SIBO is more prevalent in IBS, particularly in IBS-C, compared to controls, while it is less common in patients with IBD. In patients with IBD, methane-positive SIBO was significantly lower in Crohn's disease compared to ulcerative colitis. More studies are needed to establish a causal relationship due to the low quality of evidence and clinical heterogeneity in the current studies.
Article
Gastroenterology & Hepatology
Daniel Bushyhead, Eamonn M. M. Quigley
Summary: The concept of small intestinal bacterial overgrowth (SIBO) explains the cause of maldigestion and malabsorption. With the development of diagnostic testing, the methods for diagnosing SIBO have evolved from small bowel culture to breath tests and culture-independent microbial analytics. The availability of breath tests has led to an expansion in the diagnosis of SIBO and the associated clinical symptoms. However, issues with the specificity of breath tests have raised doubts about the role of SIBO in certain clinical scenarios. The hope is to use modern molecular microbiology to study the human small intestinal microbiome in order to provide an objective basis for diagnosing SIBO.
Review
Nutrition & Dietetics
Justyna Paulina Wielgosz-Grochowska, Nicole Domanski, Malgorzata Ewa Drywien
Summary: Small intestinal bacterial overgrowth (SIBO) is common in irritable bowel syndrome (IBS). Antibiotic treatment is the first-line approach, but focusing solely on antimicrobial effects without considering lifestyle factors and dietary patterns may lead to intestinal microbiota dysfunction. Recent studies suggest that dietary manipulation can alleviate SIBO gastrointestinal symptoms, but the efficacy of the IBS diet in SIBO remains largely hypothetical and further research is needed to establish a specific diet for SIBO treatment.
Article
Biochemistry & Molecular Biology
Sholpan Omarova, Karem Awad, Verena Moos, Christoph Puening, Greta Goelz, Jorg-Dieter Schulzke, Roland Buecker
Summary: This study observed patients with persistent PI-IBS symptoms after C. jejuni infection and found that the epithelial resistance of the colon epithelium was unaltered, but the permeability of HRP increased and some inflammation-related markers were elevated. Therefore, targeting these mechanisms caused by the infection may help reduce sequelae such as PI-IBS.
Article
Gastroenterology & Hepatology
David J. Cangemi, Brian E. Lacy, Journey Wise
Summary: This study found poor agreement between lactulose breath test (LBT) and duodenal aspiration (DA) in the evaluation of small intestinal bacterial overgrowth (SIBO). LBT may be more favorable than DA due to being safer, cheaper, and less likely to yield a contaminated result. Patients with diabetes mellitus or proton pump inhibitor (PPI) use were more likely to have a positive result in DA, while those with a history of small bowel resection were more likely to have a positive result in LBT.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Review
Medicine, General & Internal
Michael Camilleri
Summary: This narrative review summarizes the epidemiology, pathophysiology, diagnosis, management, and prognosis of irritable bowel syndrome (IBS), which has a high prevalence in the United States, especially among women and young people. The diagnosis is traditionally based on the positive identification of symptoms related to various syndromes, while treatment methods should be customized based on specific symptoms.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Article
Gastroenterology & Hepatology
Daniel Bushyhead, Eamonn M. Quigley
Summary: The concept of SIBO has undergone significant changes and challenges, with uncertainty and controversy surrounding its diagnosis. This review aims to discuss the current pathophysiology of SIBO.
GASTROENTEROLOGY CLINICS OF NORTH AMERICA
(2021)
Article
Gastroenterology & Hepatology
Michel Bouchoucha, Marinos Fysekidis, Celine Lekhal, Bakhtiar Daniel Bejou, Jean-Marc Sabate, Robert Benamouzig
Summary: The study aimed to evaluate the efficacy of COLIGENTA for SIBO symptomatology and breath test normalization, showing that a 10-day treatment of COLIGENTA led to a significant improvement in SIBO clinical conditions and can be used as the first or second treatment line.
DIGESTIVE AND LIVER DISEASE
(2021)
Article
Gastroenterology & Hepatology
Michael Camilleri, Guy Boeckxstaens
Summary: This article evaluates the evidence that targeted pathophysiological mechanisms and customized treatments can be an alternative approach to treating patients with irritable bowel syndrome (IBS). The authors conducted a literature review on the mechanisms and treatments of IBS, identifying various noninvasive clinical tests that can assess the underlying mechanisms responsible for symptom generation. These mechanisms include rectal evacuation disorders, abnormal transit, visceral hypersensitivity or hypervigilance, bile acid diarrhea, sugar intolerances, barrier dysfunction, the microbiome, immune activation, and chemicals released by these mechanisms. The authors also recognized the basic molecular mechanisms contributing to these pathophysiologies, offering opportunities for interventions with medications targeted at specific food components, receptors, and potentially the microbiome. Although the evidence supporting interventions for each mechanism varies, the current state-of-the-art allows for a shift from symptom-based treatment to individualized treatment guided by pathophysiology and clinically identified biomarkers.
Article
Gastroenterology & Hepatology
Madhusudan Grover, Antonio Berumen, Stephanie Peters, Ting Wei, Margaret Breen-Lyles, William S. Harmsen, Irene Busciglio, Duane Burton, Maria Vazquez Roque, Kenneth R. DeVault, Michael Camilleri, Michael Wallace, Surendra Dasari, Helmut Neumann, Lesley A. Houghton
Summary: This study found that patients with irritable bowel syndrome (IBS) had a stronger symptom response to small intestinal lipid infusion, which was associated with the expression of TRPV channels, suggesting that TRPV-mediated small intestinal chemosensitivity may play a role in post-meal symptoms in IBS.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2021)
Article
Health Care Sciences & Services
Xuelian Yu, Yue Li, Feng Xiang, Jingjuan Feng
Summary: SIBO is important in the development of IBS. Antibiotics and probiotics can be used in clinical practice to correct SIBO and improve symptoms and peripheral blood inflammatory factors in patients with IBS.
ANNALS OF PALLIATIVE MEDICINE
(2021)
Review
Food Science & Technology
Ao Liu, Wenkang Gao, Yixin Zhu, Xiaohua Hou, Huikuan Chu
Summary: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that significantly affects personal health and imposes a substantial economic burden on society. Emerging evidence suggests that IBS is associated with gut microbial dysbiosis, including not only bacteria but also fungi, viruses, archaea, and other parasitic microorganisms. Fungi and methanogens play a role in diagnosis and treatment of IBS.
Article
Nutrition & Dietetics
Cezary Chojnacki, Tomasz Poplawski, Paulina Konrad, Michal Fila, Janusz Blasiak, Jan Chojnacki
Summary: This study assessed the mental state and gastrointestinal complaints of patients with small intestinal bacterial overgrowth (SIBO) and found changes in tryptophan metabolism. Rifaximin treatment improved the mood disorders and gastrointestinal symptoms of the patients.
NUTRITION & METABOLISM
(2022)
Article
Gastroenterology & Hepatology
Takanori Yoshimoto, Tadayuki Oshima, Xinyi Huang, Toshihiko Tomita, Hirokazu Fukui, Hiroto Miwa
Summary: In patients with irritable bowel syndrome (IBS), an increase in duodenal mast cells and intraepithelial lymphocytes (IELs) was observed, with a positive correlation between the number of duodenal and ileal IELs and the frequency of diarrhea. Further studies are needed to clarify the pathophysiological functions associated with micro-inflammation in IBS, as this study was strictly observational.
JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Microbiology
Jonathan P. P. Jacobs, Venu Lagishetty, Megan C. C. Hauer, Jennifer S. S. Labus, Tien S. S. Dong, Ryan Toma, Momchilo Vuyisich, Bruce D. D. Naliboff, Jeffrey M. M. Lackner, Arpana Gupta, Kirsten Tillisch, Emeran A. A. Mayer
Summary: This study used multi-omics assessment methods to explore the changes in gut microbiome function in irritable bowel syndrome (IBS), and identified new microbial biomarkers. The findings support the application of integrated assessment of microbial function in IBS research, and contribute to the discovery of novel microbiome-related therapeutic targets.
