小肠细菌过度生长的诊断和治疗:巴西胃肠病学联合会的官方立场文件。

Q2 Medicine
Arquivos de Gastroenterologia Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI:10.1590/S0004-2803.24612024-107
Bruno César da Silva, Gabriela Piovezani Ramos, Luisa Leite Barros, Ana Flávia Passos Ramos, Gerson Domingues, Décio Chinzon, Maria do Carmo Friche Passos
{"title":"小肠细菌过度生长的诊断和治疗:巴西胃肠病学联合会的官方立场文件。","authors":"Bruno César da Silva, Gabriela Piovezani Ramos, Luisa Leite Barros, Ana Flávia Passos Ramos, Gerson Domingues, Décio Chinzon, Maria do Carmo Friche Passos","doi":"10.1590/S0004-2803.24612024-107","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Small intestinal bacterial overgrowth (SIBO) is a condition characterized by an abnormal increase in bacterial population in the small intestine, leading to symptoms such as bloating, abdominal pain, distension, diarrhea, and eventually malabsorption. The diagnosis and management of SIBO remain challenging due to overlapping symptoms with other gastrointestinal disorders such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and coeliac disease.</p><p><strong>Objective: </strong>This article aims to review current evidence on the diagnosis and treatment of SIBO, with a focus on strategies suitable for the Brazilian healthcare system.</p><p><strong>Methods: </strong>A comprehensive literature review was performed, focusing on clinical guidelines, randomized controlled trials, and cohort studies concerning SIBO. Diagnostic methods, including breath tests and direct aspiration techniques, were critically analyzed. Treatment approaches, including antibiotics, dietary modifications, and probiotics, were reviewed. The recommendations were formulated based on a panel of gastroenterologists, members of the Brazilian Federation of Gastroenterology (FBG), with approval from the majority of the members.</p><p><strong>Results: </strong>Breath tests using glucose and lactulose remain the most commonly used non-invasive diagnostic tools, though they are subject to limitations such as false positives and false negatives. Treatment with rifaximin is effective in most cases of SIBO, while systemic antibiotics like metronidazole and ciprofloxacin are alternatives. Probiotics and dietary interventions, particularly low FODMAP diets, can complement antibiotic therapy. Long-term follow-up is essential due to the recurrence rate, which is common in SIBO patients.</p><p><strong>Conclusion: </strong>Standardizing SIBO diagnosis and treatment in Brazil is essential to reduce diagnostic delays and optimize care, especially given the disparities and heterogeneity in clinical practice across the country. This article provides evidence-based recommendations to guide clinical practice. Further research is needed to refine diagnostic methods, explore novel treatment strategies, and better understand the specific characteristics of the Brazilian population.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e24107"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043196/pdf/","citationCount":"0","resultStr":"{\"title\":\"DIAGNOSIS AND TREATMENT OF SMALL INTESTINAL BACTERIAL OVERGROWTH: AN OFFICIAL POSITION PAPER FROM THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY.\",\"authors\":\"Bruno César da Silva, Gabriela Piovezani Ramos, Luisa Leite Barros, Ana Flávia Passos Ramos, Gerson Domingues, Décio Chinzon, Maria do Carmo Friche Passos\",\"doi\":\"10.1590/S0004-2803.24612024-107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Small intestinal bacterial overgrowth (SIBO) is a condition characterized by an abnormal increase in bacterial population in the small intestine, leading to symptoms such as bloating, abdominal pain, distension, diarrhea, and eventually malabsorption. The diagnosis and management of SIBO remain challenging due to overlapping symptoms with other gastrointestinal disorders such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and coeliac disease.</p><p><strong>Objective: </strong>This article aims to review current evidence on the diagnosis and treatment of SIBO, with a focus on strategies suitable for the Brazilian healthcare system.</p><p><strong>Methods: </strong>A comprehensive literature review was performed, focusing on clinical guidelines, randomized controlled trials, and cohort studies concerning SIBO. Diagnostic methods, including breath tests and direct aspiration techniques, were critically analyzed. Treatment approaches, including antibiotics, dietary modifications, and probiotics, were reviewed. The recommendations were formulated based on a panel of gastroenterologists, members of the Brazilian Federation of Gastroenterology (FBG), with approval from the majority of the members.</p><p><strong>Results: </strong>Breath tests using glucose and lactulose remain the most commonly used non-invasive diagnostic tools, though they are subject to limitations such as false positives and false negatives. Treatment with rifaximin is effective in most cases of SIBO, while systemic antibiotics like metronidazole and ciprofloxacin are alternatives. Probiotics and dietary interventions, particularly low FODMAP diets, can complement antibiotic therapy. Long-term follow-up is essential due to the recurrence rate, which is common in SIBO patients.</p><p><strong>Conclusion: </strong>Standardizing SIBO diagnosis and treatment in Brazil is essential to reduce diagnostic delays and optimize care, especially given the disparities and heterogeneity in clinical practice across the country. This article provides evidence-based recommendations to guide clinical practice. Further research is needed to refine diagnostic methods, explore novel treatment strategies, and better understand the specific characteristics of the Brazilian population.</p>\",\"PeriodicalId\":35671,\"journal\":{\"name\":\"Arquivos de Gastroenterologia\",\"volume\":\"62 \",\"pages\":\"e24107\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043196/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arquivos de Gastroenterologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1590/S0004-2803.24612024-107\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arquivos de Gastroenterologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/S0004-2803.24612024-107","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

背景:小肠细菌过度生长(SIBO)是一种以小肠细菌数量异常增加为特征的疾病,可导致腹胀、腹痛、腹胀、腹泻等症状,最终导致吸收不良。SIBO的诊断和治疗仍然具有挑战性,因为它与其他胃肠道疾病如炎症性肠病(IBD)、肠易激综合征(IBS)和乳糜泻重叠。目的:本文旨在回顾目前的证据对SIBO的诊断和治疗,重点是战略适合巴西卫生保健系统。方法:对SIBO相关的临床指南、随机对照试验和队列研究进行全面的文献综述。诊断方法,包括呼吸试验和直接吸入技术,进行了严格的分析。治疗方法,包括抗生素,饮食调整和益生菌,进行了回顾。这些建议是根据巴西胃肠病学联合会(FBG)成员的胃肠病学家小组制定的,并得到了大多数成员的批准。结果:使用葡萄糖和乳果糖的呼吸测试仍然是最常用的非侵入性诊断工具,尽管它们受到假阳性和假阴性等限制。在大多数SIBO病例中,利福昔明治疗是有效的,而甲硝唑和环丙沙星等全身抗生素是替代方案。益生菌和饮食干预,特别是低FODMAP饮食,可以补充抗生素治疗。由于复发率,长期随访是必要的,这在SIBO患者中很常见。结论:巴西SIBO诊断和治疗的标准化对于减少诊断延误和优化护理至关重要,特别是考虑到全国临床实践的差异和异质性。本文提供循证建议以指导临床实践。需要进一步的研究来完善诊断方法,探索新的治疗策略,并更好地了解巴西人群的具体特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
DIAGNOSIS AND TREATMENT OF SMALL INTESTINAL BACTERIAL OVERGROWTH: AN OFFICIAL POSITION PAPER FROM THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY.

Background: Small intestinal bacterial overgrowth (SIBO) is a condition characterized by an abnormal increase in bacterial population in the small intestine, leading to symptoms such as bloating, abdominal pain, distension, diarrhea, and eventually malabsorption. The diagnosis and management of SIBO remain challenging due to overlapping symptoms with other gastrointestinal disorders such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and coeliac disease.

Objective: This article aims to review current evidence on the diagnosis and treatment of SIBO, with a focus on strategies suitable for the Brazilian healthcare system.

Methods: A comprehensive literature review was performed, focusing on clinical guidelines, randomized controlled trials, and cohort studies concerning SIBO. Diagnostic methods, including breath tests and direct aspiration techniques, were critically analyzed. Treatment approaches, including antibiotics, dietary modifications, and probiotics, were reviewed. The recommendations were formulated based on a panel of gastroenterologists, members of the Brazilian Federation of Gastroenterology (FBG), with approval from the majority of the members.

Results: Breath tests using glucose and lactulose remain the most commonly used non-invasive diagnostic tools, though they are subject to limitations such as false positives and false negatives. Treatment with rifaximin is effective in most cases of SIBO, while systemic antibiotics like metronidazole and ciprofloxacin are alternatives. Probiotics and dietary interventions, particularly low FODMAP diets, can complement antibiotic therapy. Long-term follow-up is essential due to the recurrence rate, which is common in SIBO patients.

Conclusion: Standardizing SIBO diagnosis and treatment in Brazil is essential to reduce diagnostic delays and optimize care, especially given the disparities and heterogeneity in clinical practice across the country. This article provides evidence-based recommendations to guide clinical practice. Further research is needed to refine diagnostic methods, explore novel treatment strategies, and better understand the specific characteristics of the Brazilian population.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Arquivos de Gastroenterologia
Arquivos de Gastroenterologia Medicine-Gastroenterology
CiteScore
2.00
自引率
0.00%
发文量
109
审稿时长
9 weeks
期刊介绍: The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信