First Department of Internal Medicine, IRCCS S. Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas.
Neurogastroenterol Motil. 2018 Nov;30(11):e13494. doi: 10.1111/nmo.13494.
Small intestinal bacterial overgrowth (SIBO) was originally described decades ago as a cause of malabsorption among individuals with abnormal intestinal anatomy and/or impaired gastric acid secretion and intestinal motor functions. More recently, the concept of SIBO has been expanded to explain symptoms among a much broader patient population-a move that brings the definition of SIBO into much sharper focus. For largely logistical reasons, breath tests and, especially, those based on the excretion of hydrogen consequent on the fermentation of unabsorbed carbohydrate substrates, have almost entirely replaced jejunal aspirates in the diagnosis of SIBO. Ever bedeviled by concerns regarding their reliability, hydrogen breath tests have now come under even more critical scrutiny with the study from Sundin and colleagues in this issue suggesting that their sole function is to detect carbohydrate malabsorption and that they are incapable of defining SIBO.
小肠细菌过度生长（SIBO）最初是几十年前描述的一种在肠道解剖和/或胃酸分泌及肠道运动功能异常的个体中引起吸收不良的原因。最近，SIBO 的概念已经扩展到解释更广泛的患者群体的症状——这一举措使 SIBO 的定义更加明确。由于主要是出于后勤原因，呼气试验，尤其是基于未吸收碳水化合物底物发酵产生的氢气排泄的呼气试验，几乎完全取代了空肠抽吸术在 SIBO 的诊断中。由于对其可靠性的担忧，氢呼气试验现在受到了更严格的审查， Sundin 及其同事在本期杂志上的研究表明，它们唯一的功能是检测碳水化合物吸收不良，而不能定义 SIBO。
