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Review article: small intestinal bacterial overgrowth – prevalence, clinical features, current and developing diagnostic tests, and treatment
Author(s) -
Grace E.,
Shaw C.,
Whelan K.,
Andreyev H. J. N.
Publication year - 2013
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12456
Subject(s) - small intestinal bacterial overgrowth , medicine , gold standard (test) , diagnostic test , intensive care medicine , bacterial overgrowth , confusion , medline , antibiotics , gastroenterology , irritable bowel syndrome , pediatrics , microbiology and biotechnology , psychology , political science , psychoanalysis , law , biology
Summary Background The symptoms and signs of small intestinal bacterial overgrowth (SIBO) are often identical to a variety of diseases and can lead to diagnostic confusion. Aims To review the diagnostic options for SIBO and present new investigative options for the condition. Methods A 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’. Results All 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. Conclusions Novel diagnostic options are needed to supplement or replace available tests.