СИНДРОМ ИЗБЫТОЧНОГО БАКТЕРИАЛЬНОГО РОСТА В ТОНКОЙ КИШКЕ: СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ
Аннотация
В обзорной статье представлены обобщённые современные данные, касающиеся дефиниций, этиологии, патогенеза и клинических проявлений синдрома избыточного бактериального роста в тонкой кишке. Приведены сведения о нормальном составе микрофлоры тонкой кишки и различных патологических состояниях, приводящих к её нарушениям. Рассмотрены преимущества и недостатки предлагаемых диагностических (культуральное исследование дуоденального аспирата, водородные и метановый дыхательные тесты) и лечебных (антибиотики, пробиотики, диета с ограничением ферментируемых олиго-, ди-, моносахаров и полиолов, трансплантация фекальной микробиоты) подходов.
Литература
1. Allegretti J.R., Kassam Z., Chan W.W. Small intestinal bacterial overgrowth: Should screening be included in the pre-fecal microbiota transplantation evaluation? Dig Dis Sci. 2018; 63: 193-197. doi: 10.1007/s10620-017-4864-8.
2. Bhagatwala J.S.A., Leelasinjaroen P., Tetangco E. et al. Investigation of small intestinal bacterial overgrowth (SIBO) in diabetics using fructose breath test. Gastroenterology. 2018; 154: 53-54.
3. Chang B.W., Rezaie A. Irritable bowel syndrome-like symptoms following fecal microbiota transplantation: A possible donor-dependent complication. Am J Gastroenterol. 2017; 112: 186–187. doi: 10.1038/ajg.2016.472.
4. Charlesworth R.P.G, Winter G. Small intestinal bacterial overgrowth and Celiac disease - coincidence or causation? Expert Rev Gastroenterol Hepatol. 2020 May; 14(5): 305-306. doi: 10.1080/17474124.2020.1757428.
5. Erdogan A., Rao S.S. Small intestinal fungal overgrowth. Curr Gastroenterol Rep. 2015; 17: 16. doi: 10.1007/s11894-015-0436-2.
6. Erdogan A., Rao S.S., Gulley D. et al. Small intestinal bacterial overgrowth: Duodenal aspiration vs glucose breath test. Neurogastroenterol Motil. 2015; 27: 481–489. doi: 10.1111/nmo.12516.
7. Erdrich S., Hawrelak J.A., Myers S.P., Harnett J.E. Determining the association between fibromyalgia, the gut microbiome and its biomarkers: A systematic review. BMC Musculoskelet Disord. 2020 Mar 20; 21(1): 181. doi: 10.1186/s12891-020-03201-9.
8. Furnari M., De Alessandri A., Cresta F. et al. The role of small intestinal bacterial overgrowth in cystic fibrosis: a randomized case-controlled clinical trial with rifaximin. J Gastroenterol. 2019 Mar; 54(3): 261-270. doi: 10.1007/s00535-018-1509-4.
9. Gabbard S.L., Lacy B.E., Levine G.M. et al. The impact of alcohol consumption and cholecystectomy on small intestinal bacterial overgrowth. Dig Dis Sci. 2014; 59: 638-644. doi: 10.1007/s10620-013-2960-y.
10. Gatta L, Scarpignato C. Systematic review with meta-analysis: Rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth. Aliment Pharmacol Ther. 2017; 45: 604-616. doi: 10.1111/apt.13928.
11. Ghosh G., Jesudian A.B. Small Intestinal Bacterial Overgrowth in Patients With Cirrhosis. J Clin Exp Hepatol. 2019 Mar-Apr; 9(2): 257-267. doi: 10.1016/j.jceh.2018.08.006.
12. Ghoshal U.C., Ghoshal U. Small intestinal bacterial overgrowth and other intestinal disorders. Gastroenterol Clin North Am. 2017; 46: 103-120. doi: 10.1016/j.gtc.2016.09.008.
13. Giamarellos-Bourboulis E., Tang J., Pyleris E. et al. Molecular assessment of differences in the duodenal microbiome in subjects with irritable bowel syndrome. Scand J Gastroenterol. 2015; 50: 1076–1087. doi: 10.3109/00365521.2015.1027261.
14. Kalantar-Zadeh K., Berean K.J., Ha N. et al. A human pilot trial of ingestible electronic capsules capable of sensing different gases in the gut. Nat Electronics. 2018; 1: 79–87.
15. Kim G., Deepinder F., Morales W. et al. Methanobrevibacter smithiiis the predominant methanogen in patients with constipation-predominant IBS and methane on breath. Dig Dis Sci. 2012; 57: 32-38. doi: 10.1007/s10620-012-2197-1.
16. Kumar K., Saadi M., Ramsey F.V. et al. Effect of Bifidobacterium infantis 35624 (Align) on the lactulose breath test for small intestinal bacterial overgrowth. Dig Dis Sci. 2018; 63: 989-995. doi: 10.1007/s10620-018-4945-3.
17. Lee A.A., Baker J.R., Wamsteker E.J. et al. Small Intestinal Bacterial Overgrowth Is Common in Chronic Pancreatitis and Associates With Diabetes, Chronic Pancreatitis Severity, Low Zinc Levels, and Opiate Use. Am J Gastroenterol. 2019 Jul; 114(7): 1163-1171. doi: 10.14309/ajg.0000000000000200.
18. Leventogiannis K., Gkolfakis P., Spithakis G. et al. Effect of a preparation of four probiotics on symptoms of patients with irritable bowel syndrome: Association with intestinal bacterial overgrowth. Probiotics Antimicrob Proteins. 2019; 11: 627-634. doi: 10.1007/s12602-018-9401-3.
19. Lin E.C.K., Pichetshote N., Rezaie A. et al. Measurement of hydrogen sulfide during breath testing correlates to patient symptoms. Gastroenterology. 2017; 152: 205–206.
20. McIntosh K., Reed D.E., Schneider T. et al. FODMAPs alter symptoms and the metabolome of patients with IBS: A randomised controlled trial. Gut. 2017; 66: 1241–1251. doi: 10.1136/gutjnl-2015-311339.
21. Pimentel M. Review article: potential mechanisms of action of rifaximin in the management of irritable bowel syndrome with diarrhoea. Aliment Pharmacol Ther. 2016 Jan; 43 Suppl 1: 37-49. doi: 10.1111/apt.13437.
22. Pimentel M., Saad R.J., Long M.D., Rao S.S.C. ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. Am J Gastroenterol. 2020 Feb; 115(2): 165-178. doi: 10.14309/ajg.0000000000000501.
23. Polkowska-Pruszynska B., Gerkowicz A., Szczepanik-Kulak P. et al. Small intestinal bacterial overgrowth in systemic sclerosis: A review of the literature. Arch Dermatol Res. 2019; 311: 1–8. doi: 10.1007/s00403-018-1874-0.
24. Rao S.S.C., Rehman A., Yu S. et al. Brain fogginess, gas and bloating: A link between SIBO, probiotics and metabolic acidosis. Clin Transl Gastroenterol. 2018; 9: 162. doi: 10.1038/s41424-018-0030-7.
25. Rezaie A., Buresi M., Lembo A. et al. Hydrogen and methane-based breath testing in gastrointestinal disorders: The North American consensus. Am J Gastroenterol. 2017; 112: 775–784. doi: 10.1038/ajg.2017.46.
26. Safi M.A., Jiman-Fatani A.A., Saadah O.I. Small intestinal bacterial overgrowth among patients with celiac disease unresponsive to a gluten free diet. Turk J Gastroenterol. 2020 Nov; 31(11): 767-774. doi: 10.5152/tjg.2020.19627.
27. Singh S., Allan N., Wahl C. et al. Sa1717 - Development of a swallowable diganostic capsule to monitor gastrointestinal health. Gastroenterology. 2019; 156: S-376.
28. Su T., Lai S., Lee A. et al. Meta-analysis: Proton pump inhibitors moderately increase the risk of small intestinal bacterial overgrowth. J Gastroenterol. 2018; 53: 27-36. doi: 10.1007/s00535-017-1371-9.
29. Therrien A., Bouchard S., Sidani S. et al. Prevalence of small intestinal bacterial overgrowth among chronic pancreatitis patients: A case-control study. Can J Gastroenterol Hepatol. 2016; 2016: 7424831. DOI: 10.1155/2016/7424831.
30. U.S. Food and Drug Administration. Important safety alert regarding use of fecal microbiota for transplantation and risk of serious adverse reactions due to transmission of multi-drug resistant organisms. 2019. URL: https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-safety-alert-regarding-use-fecal-microbiota-transplantation-and-risk-serious-adverse (дата обращения 09.10.2021).
31. Zhang Y., Liu G., Duan Y. et al. Prevalence of Small Intestinal Bacterial Overgrowth in Multiple Sclerosis: a Case-Control Study from China. J Neuroimmunol. 2016 Dec 15; 301: 83-87. doi: 10.1016/j.jneuroim.2016.11.004.
32. Zhong C., Qu C., Wang B. et al. Probiotics for preventing and treating small intestinal bacterial overgrowth: A meta-analysis and systematic review of current evidence. J Clin Gastroenterol. 2017; 51: 300-311. doi: 10.1097/MCG.0000000000000814.
2. Bhagatwala J.S.A., Leelasinjaroen P., Tetangco E. et al. Investigation of small intestinal bacterial overgrowth (SIBO) in diabetics using fructose breath test. Gastroenterology. 2018; 154: 53-54.
3. Chang B.W., Rezaie A. Irritable bowel syndrome-like symptoms following fecal microbiota transplantation: A possible donor-dependent complication. Am J Gastroenterol. 2017; 112: 186–187. doi: 10.1038/ajg.2016.472.
4. Charlesworth R.P.G, Winter G. Small intestinal bacterial overgrowth and Celiac disease - coincidence or causation? Expert Rev Gastroenterol Hepatol. 2020 May; 14(5): 305-306. doi: 10.1080/17474124.2020.1757428.
5. Erdogan A., Rao S.S. Small intestinal fungal overgrowth. Curr Gastroenterol Rep. 2015; 17: 16. doi: 10.1007/s11894-015-0436-2.
6. Erdogan A., Rao S.S., Gulley D. et al. Small intestinal bacterial overgrowth: Duodenal aspiration vs glucose breath test. Neurogastroenterol Motil. 2015; 27: 481–489. doi: 10.1111/nmo.12516.
7. Erdrich S., Hawrelak J.A., Myers S.P., Harnett J.E. Determining the association between fibromyalgia, the gut microbiome and its biomarkers: A systematic review. BMC Musculoskelet Disord. 2020 Mar 20; 21(1): 181. doi: 10.1186/s12891-020-03201-9.
8. Furnari M., De Alessandri A., Cresta F. et al. The role of small intestinal bacterial overgrowth in cystic fibrosis: a randomized case-controlled clinical trial with rifaximin. J Gastroenterol. 2019 Mar; 54(3): 261-270. doi: 10.1007/s00535-018-1509-4.
9. Gabbard S.L., Lacy B.E., Levine G.M. et al. The impact of alcohol consumption and cholecystectomy on small intestinal bacterial overgrowth. Dig Dis Sci. 2014; 59: 638-644. doi: 10.1007/s10620-013-2960-y.
10. Gatta L, Scarpignato C. Systematic review with meta-analysis: Rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth. Aliment Pharmacol Ther. 2017; 45: 604-616. doi: 10.1111/apt.13928.
11. Ghosh G., Jesudian A.B. Small Intestinal Bacterial Overgrowth in Patients With Cirrhosis. J Clin Exp Hepatol. 2019 Mar-Apr; 9(2): 257-267. doi: 10.1016/j.jceh.2018.08.006.
12. Ghoshal U.C., Ghoshal U. Small intestinal bacterial overgrowth and other intestinal disorders. Gastroenterol Clin North Am. 2017; 46: 103-120. doi: 10.1016/j.gtc.2016.09.008.
13. Giamarellos-Bourboulis E., Tang J., Pyleris E. et al. Molecular assessment of differences in the duodenal microbiome in subjects with irritable bowel syndrome. Scand J Gastroenterol. 2015; 50: 1076–1087. doi: 10.3109/00365521.2015.1027261.
14. Kalantar-Zadeh K., Berean K.J., Ha N. et al. A human pilot trial of ingestible electronic capsules capable of sensing different gases in the gut. Nat Electronics. 2018; 1: 79–87.
15. Kim G., Deepinder F., Morales W. et al. Methanobrevibacter smithiiis the predominant methanogen in patients with constipation-predominant IBS and methane on breath. Dig Dis Sci. 2012; 57: 32-38. doi: 10.1007/s10620-012-2197-1.
16. Kumar K., Saadi M., Ramsey F.V. et al. Effect of Bifidobacterium infantis 35624 (Align) on the lactulose breath test for small intestinal bacterial overgrowth. Dig Dis Sci. 2018; 63: 989-995. doi: 10.1007/s10620-018-4945-3.
17. Lee A.A., Baker J.R., Wamsteker E.J. et al. Small Intestinal Bacterial Overgrowth Is Common in Chronic Pancreatitis and Associates With Diabetes, Chronic Pancreatitis Severity, Low Zinc Levels, and Opiate Use. Am J Gastroenterol. 2019 Jul; 114(7): 1163-1171. doi: 10.14309/ajg.0000000000000200.
18. Leventogiannis K., Gkolfakis P., Spithakis G. et al. Effect of a preparation of four probiotics on symptoms of patients with irritable bowel syndrome: Association with intestinal bacterial overgrowth. Probiotics Antimicrob Proteins. 2019; 11: 627-634. doi: 10.1007/s12602-018-9401-3.
19. Lin E.C.K., Pichetshote N., Rezaie A. et al. Measurement of hydrogen sulfide during breath testing correlates to patient symptoms. Gastroenterology. 2017; 152: 205–206.
20. McIntosh K., Reed D.E., Schneider T. et al. FODMAPs alter symptoms and the metabolome of patients with IBS: A randomised controlled trial. Gut. 2017; 66: 1241–1251. doi: 10.1136/gutjnl-2015-311339.
21. Pimentel M. Review article: potential mechanisms of action of rifaximin in the management of irritable bowel syndrome with diarrhoea. Aliment Pharmacol Ther. 2016 Jan; 43 Suppl 1: 37-49. doi: 10.1111/apt.13437.
22. Pimentel M., Saad R.J., Long M.D., Rao S.S.C. ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. Am J Gastroenterol. 2020 Feb; 115(2): 165-178. doi: 10.14309/ajg.0000000000000501.
23. Polkowska-Pruszynska B., Gerkowicz A., Szczepanik-Kulak P. et al. Small intestinal bacterial overgrowth in systemic sclerosis: A review of the literature. Arch Dermatol Res. 2019; 311: 1–8. doi: 10.1007/s00403-018-1874-0.
24. Rao S.S.C., Rehman A., Yu S. et al. Brain fogginess, gas and bloating: A link between SIBO, probiotics and metabolic acidosis. Clin Transl Gastroenterol. 2018; 9: 162. doi: 10.1038/s41424-018-0030-7.
25. Rezaie A., Buresi M., Lembo A. et al. Hydrogen and methane-based breath testing in gastrointestinal disorders: The North American consensus. Am J Gastroenterol. 2017; 112: 775–784. doi: 10.1038/ajg.2017.46.
26. Safi M.A., Jiman-Fatani A.A., Saadah O.I. Small intestinal bacterial overgrowth among patients with celiac disease unresponsive to a gluten free diet. Turk J Gastroenterol. 2020 Nov; 31(11): 767-774. doi: 10.5152/tjg.2020.19627.
27. Singh S., Allan N., Wahl C. et al. Sa1717 - Development of a swallowable diganostic capsule to monitor gastrointestinal health. Gastroenterology. 2019; 156: S-376.
28. Su T., Lai S., Lee A. et al. Meta-analysis: Proton pump inhibitors moderately increase the risk of small intestinal bacterial overgrowth. J Gastroenterol. 2018; 53: 27-36. doi: 10.1007/s00535-017-1371-9.
29. Therrien A., Bouchard S., Sidani S. et al. Prevalence of small intestinal bacterial overgrowth among chronic pancreatitis patients: A case-control study. Can J Gastroenterol Hepatol. 2016; 2016: 7424831. DOI: 10.1155/2016/7424831.
30. U.S. Food and Drug Administration. Important safety alert regarding use of fecal microbiota for transplantation and risk of serious adverse reactions due to transmission of multi-drug resistant organisms. 2019. URL: https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-safety-alert-regarding-use-fecal-microbiota-transplantation-and-risk-serious-adverse (дата обращения 09.10.2021).
31. Zhang Y., Liu G., Duan Y. et al. Prevalence of Small Intestinal Bacterial Overgrowth in Multiple Sclerosis: a Case-Control Study from China. J Neuroimmunol. 2016 Dec 15; 301: 83-87. doi: 10.1016/j.jneuroim.2016.11.004.
32. Zhong C., Qu C., Wang B. et al. Probiotics for preventing and treating small intestinal bacterial overgrowth: A meta-analysis and systematic review of current evidence. J Clin Gastroenterol. 2017; 51: 300-311. doi: 10.1097/MCG.0000000000000814.
Опубликована
2023-01-15
Как цитировать
ТОМАШ, О. В. et al.
СИНДРОМ ИЗБЫТОЧНОГО БАКТЕРИАЛЬНОГО РОСТА В ТОНКОЙ КИШКЕ: СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ.
Университетская клиника, [S.l.], n. 1(42), p. 45-52, янв. 2023.
ISSN 1819-0464. Доступно на: <http://journal.dnmu.ru/index.php/UC/article/view/791>. Дата доступа: 24 апр. 2024
Раздел
Обзоры
