Goulet O, Joly F
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Necker-Enfants Malades, University of Paris-Descartes, Paris, France.
Gastroenterol Clin Biol. 2010 Sep;34 Suppl 1:S37-43. doi: 10.1016/S0399-8320(10)70019-1.
Short bowel syndrome (SBS) is the main cause of intestinal failure especially in children. The colon is a crucial partner for small intestine adaptation and function in patients who have undergone extensive small bowel resection. However, SBS predisposes the patient to small intestine bacterial overgrowth (SIBO), explaining its high prevalence in patients with this disorder. SIBO may significantly compromise digestive and absorptive functions and may delay or prevent weaning from total parenteral nutrition (TPN). Moreover, SIBO may be one of the causes of intestinal failure-associated liver disease, requiring liver transplantation in some cases. Traditional tests for assessing SIBO may be unreliable in SBS patients. Management of SIBO with antibiotic therapy as a first-line approach remains a matter of debate, while other approaches, including probiotics, offer potential based on experimental evidence, though only few data from human studies are available.
短肠综合征(SBS)是肠道衰竭的主要原因,尤其是在儿童中。结肠是广泛小肠切除术后患者小肠适应和功能的关键伙伴。然而,SBS使患者易患小肠细菌过度生长(SIBO),这解释了该疾病患者中SIBO的高患病率。SIBO可能会显著损害消化和吸收功能,并可能延迟或阻止从全肠外营养(TPN)中撤机。此外,SIBO可能是肠道衰竭相关肝病的原因之一,在某些情况下需要进行肝移植。评估SIBO的传统检测方法在SBS患者中可能不可靠。将抗生素治疗作为一线方法来管理SIBO仍存在争议,而其他方法,包括益生菌,虽仅有少量来自人体研究的数据,但基于实验证据具有潜在应用价值。