Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T09:17:37.175Z Has data issue: false hasContentIssue false
  • English
  • Français

Small intestinal bacterial overgrowth in older people

Published online by Cambridge University Press:  15 June 2015

Syed Amer  and
Huma S Manzar
Syed Amer*
Affiliation:
Department of Internal Medicine, Mayo Clinic, Phoenix, Arizona, USA
Huma S Manzar
Affiliation:
Department of Medicine, Shadan Institute of Medical Sciences, Hyderabad, Telangana, India
*
Address for correspondence: Dr Syed Amer, Department of Medicine, Mayo Clinic, Phoenix, AZ 85054, USA. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Small intestinal bacterial overgrowth (SIBO) is a condition in which non-native bacteria and/or native bacteria are present in increased numbers in the small bowel, resulting in excessive fermentation, inflammation or malabsorption. Patients with SIBO vary in presentation, from being only mildly symptomatic to suffering from chronic diarrhoea, weight loss and malabsorption. A number of diagnostic tests are currently available, with aspiration of the small intestinal fluid being the gold standard. Treatment encompasses a multimodal approach including treatment of the underlying disease, nutritional support and antibiotic therapy. In this review, we discuss the risk factors, clinical manifestations, diagnosis and treatment of SIBO in older people.

Keywords

small intestinal bacterial overgrowthdiarrhoeabloatingaspiratebreath testantibiotics
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 25 , Issue 2 , May 2015 , pp. 81 - 85
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Bouhnik, Y, Alain, S, Attar, A et al. Bacterial populations contaminating the upper gut in patients with small intestinal bacterial overgrowth syndrome. Am J Gastroenterol 1999; 94: 1327–31.Google Scholar
2 Almeida, JA, Kim, R, Stoita, A et al. Lactose malabsorption in the elderly, role of small intestinal bacterial overgrowth. Scand J Gastroenterol 2008; 43: 146–54.Google Scholar
3 McEvoy, A, Dutton, J, James, OF. Bacterial contamination of the small intestine is an important cause of occult malabsorption in the elderly. Br Med J (Clin Res Ed) 1983; 287: 789–93.Google Scholar
4 Parlesak, A, Klein, B, Schecher, K et al. Prevalence of small bowel bacterial overgrowth and its association with nutrition intake in non-hospitalised older adults. J Am Geriatr Soc 2003; 51: 768–73.Google Scholar
5 Mitsui, T, Shimaoka, K, Goto, Y et al. Small bowel bacterial overgrowth is not seen in healthy adults but is in disabled older adults. Hepatogastroenterology 2006; 53: 82–85.Google Scholar
6 Goldstein, F, Wirts, CW, Kowlessar, OD. Diabetic diarrhea and steatorrhea: Microbiologic and clinical observations. Ann Intern Med 1970; 72: 215–18.Google Scholar
7 Kahn, IJ, Jeffries, GH, Sleisenger, MH. Malabsorption in intestinal scleroderma: correction by antibiotics. N Engl J Med 1966; 274: 1339–44.Google Scholar
8 Tursi, A, Brandimarte, G, Giorgetti, G. High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal. Am J Gastroenterol 2003; 98: 839–43.Google Scholar
9 Pearson, AJ, Brezechwa-Ajdukiewicz, A, McCarthy, CF. Intestinal pseudo-obstruction with bacterial overgrowth in the small intestine. Am J Dig Dis 1969; 14: 200–5.Google Scholar
10 Pereira, SP, Gainsborough, N, Dowling, RH. Drug-induced hypochlorhydria causes high duodenal bacterial counts in the elderly. Aliment Pharmacol Ther 1998; 12: 99–104.Google Scholar
11 Browning, GG, Buchan, KA, Mackay, C. The effect of vagotomy and drainage on the small bowel flora. Gut 1974; 15: 139–42.Google Scholar
12 Gunnarsdottir, SA, Sadik, R, Shev, S et al. Small intestinal motility disturbances and bacterial overgrowth in patients with liver cirrhosis and portal hypertension. Am J Gastroenterol 2003; 98: 1362–70.Google Scholar
13 Lembeke, B, Kraus, B, Lankisch, PG. Small intestinal function in chronic relapsing pancreatitis. Hepatogastroenterology 1985; 32: 149–51.Google Scholar
14 Strid, H, Simren, M, Stotzer, PO et al. Patients with chronic renal failure have abnormal small intestinal motility and a high prevalence of small intestinal bacterial overgrowth. Digestion 2003; 67: 129–37.Google Scholar
15 Husebye, E, Skar, V, Hoverstad, T et al. Abnormal intestinal motor patterns explain enteric colonization with gram-negative bacilli in late radiation enteropathy. Gastroenterology 1995; 109: 1078–89.Google Scholar
16 Henriksson, AE, Blomquist, L, Nord, CE et al. Small intestinal bacterial overgrowth in patients with rheumatoid arthritis. Ann Rheum Dis 1993; 52: 503–10.Google Scholar
17 Weinstock, LB, Klutke, CG, Lin, HC. Small intestinal bacterial overgrowth in patients with interstitial cystitis and gastrointestinal symptoms. Dig Dis Sci 2007; 53: 1246–51.Google Scholar
18 Parodi, A, Paolino, S, Greco, A et al. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clin Gastroenterol Hepatol 2008; 6: 759–64.Google Scholar
19 Sabate, JM, Jouet, P, Harnois, F et al. High prevalence of small intestinal bacterial overgrowth in patients with morbid obesity: a contributor to severe hepatic steatosis. Obes Surg 2008; 18: 371–77.Google Scholar
20 Pimentel, M, Wallace, D, Hallegua, D et al. A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing. Ann Rheum Dis 2004; 63: 450–52.Google Scholar
21 Resmini, E, Parodi, A, Savarino, V et al. Evidence of prolonged orocecal transit time and small bowel bacterial overgrowth in acromegalic patients. J Clin Endocrinol Metab 2007; 92: 2119–24.Google Scholar
22 Toskes, PP, Giannella, RA, Jervis, HR et al. Small intestinal mucosal injury in the experimental blind loop syndrome. Light- and electron-microscopic and histochemical studies. Gastroenterology 1975; 68: 193–203.Google Scholar
23 Sherman, P, Wesley, A, Forstner, G. Sequential disaccharidase loss in rat intestinal blind loops: Impact of malnutrition. Am J Physiol 1985; 248: G626–32.Google Scholar
24 Tabaqchali, S, Hatzioannou, J, Booth, CC. Bile salt deconjugation and steatorrhoea in patients with the stagnant loop syndrome. Lancet 1968; 2: 12–16.Google Scholar
25 Sherman, P, Lichtman, S. Small bowel bacterial overgrowth syndrome. Dig Dis 1987; 5: 157–71.Google Scholar
26 Giannella, RA, Broitman, SA, Zamchek, N. Competition between bacteria and intrinsic factor for vitamin B. Gastroenterology 1972; 62: 255–60.Google Scholar
27Di Stefano, M, Veneto, G, Malservisi, S, Corazza, GR. Small intestinal bacterial overgrowth and metabolic bone disease. Dig Dis Sci 2001; 46: 1077–82.Google Scholar
28 Stotzer, PO, Johansson, C, Mellstrom, D et al. Bone mineral density in patients with small intestinal bacterial overgrowth. Hepatogastroenterology 2003; 50: 1415–18.Google Scholar
29 Soudah, HC, Hasler, WL, Owyang, C. Effect of octreotide on intestinal motility and bacterial overgrowth in scleroderma. N Engl J Med 1991; 325: 1461–67.Google Scholar
30 Schiffrin, EJ, Parlesak, A, Bode, C. Probiotic yogurt in the elderly with intestinal bacterial overgrowth: endotoxaemia and innate immune functions. Br J Nutr 2009; 101: 961–66.Google Scholar