Efremova I, Maslennikov R, Poluektova E, Vasilieva E, Zharikov Y, Suslov A, Letyagina Y, Kozlov E, Levshina A, Ivashkin V. Epidemiology of small intestinal bacterial overgrowth. World J Gastroenterol 2023; 29(22): 3400-3421 [PMID: 37389240 DOI: 10.3748/wjg.v29.i22.3400]
Corresponding Author of This Article
Roman Maslennikov, MD, PhD, Academic Editor, Assistant Professor, Doctor, Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya str., 1, bld. 1, Moscow 119435, Russia. mmmm00@yandex.ru
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 14, 2023; 29(22): 3400-3421 Published online Jun 14, 2023. doi: 10.3748/wjg.v29.i22.3400
Epidemiology of small intestinal bacterial overgrowth
Irina Efremova, Roman Maslennikov, Elena Poluektova, Ekaterina Vasilieva, Yury Zharikov, Andrey Suslov, Yana Letyagina, Evgenii Kozlov, Anna Levshina, Vladimir Ivashkin
Irina Efremova, Roman Maslennikov, Elena Poluektova, Ekaterina Vasilieva, Anna Levshina, Vladimir Ivashkin, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Moscow 119435, Russia
Roman Maslennikov, Elena Poluektova, Vladimir Ivashkin, The Scientific Community for Human Microbiome Research, Moscow 119435, Russia
Yury Zharikov, Andrey Suslov, Department of Human Anatomy and Histology, Sechenov University, Moscow 125009, Russia
Yana Letyagina, N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov University, Moscow 119991, Russia
Evgenii Kozlov, Anna Levshina, Department of Clinical Immunology and Allergy, Sechenov University, Moscow 119991, Russia
Author contributions: Ivashkin V reviewed the idea; all authors contributed to the draft editing; Maslennikov R is the guarantor.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Roman Maslennikov, MD, PhD, Academic Editor, Assistant Professor, Doctor, Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya str., 1, bld. 1, Moscow 119435, Russia. mmmm00@yandex.ru
Received: March 16, 2023 Peer-review started: March 16, 2023 First decision: March 24, 2023 Revised: March 31, 2023 Accepted: May 11, 2023 Article in press: May 11, 2023 Published online: June 14, 2023
Abstract
Small intestinal bacterial overgrowth (SIBO) is defined as an increase in the bacterial content of the small intestine above normal values. The presence of SIBO is detected in 33.8% of patients with gastroenterological complaints who underwent a breath test, and is significantly associated with smoking, bloating, abdominal pain, and anemia. Proton pump inhibitor therapy is a significant risk factor for SIBO. The risk of SIBO increases with age and does not depend on gender or race. SIBO complicates the course of a number of diseases and may be of pathogenetic significance in the development of their symptoms. SIBO is significantly associated with functional dyspepsia, irritable bowel syndrome, functional abdominal bloating, functional constipation, functional diarrhea, short bowel syndrome, chronic intestinal pseudo-obstruction, lactase deficiency, diverticular and celiac diseases, ulcerative colitis, Crohn’s disease, cirrhosis, metabolic-associated fatty liver disease (MAFLD), primary biliary cholangitis, gastroparesis, pancreatitis, cystic fibrosis, gallstone disease, diabetes, hypothyroidism, hyperlipidemia, acromegaly, multiple sclerosis, autism, Parkinson’s disease, systemic sclerosis, spondylarthropathy, fibromyalgia, asthma, heart failure, and other diseases. The development of SIBO is often associated with a slowdown in orocecal transit time that decreases the normal clearance of bacteria from the small intestine. The slowdown of this transit may be due to motor dysfunction of the intestine in diseases of the gut, autonomic diabetic polyneuropathy, and portal hypertension, or a decrease in the motor-stimulating influence of thyroid hormones. In a number of diseases, including cirrhosis, MAFLD, diabetes, and pancreatitis, an association was found between disease severity and the presence of SIBO. Further work on the effect of SIBO eradication on the condition and prognosis of patients with various diseases is required.
Core Tip: Small intestinal bacterial overgrowth (SIBO) is common in functional and organic bowel diseases, liver diseases, other diseases of digestive organs, a number of endocrine, nervous, and rheumatic diseases, asthma, heart failure, and certain other diseases. In a number of diseases, including cirrhosis, metabolic-associated fatty liver disease, diabetes mellitus, pancreatitis, and cystic fibrosis, an association was found between disease severity and the presence of SIBO. Further work on the effect of SIBO eradication on the condition and prognosis of patients in various diseases is required.
