Quigley Eamonn M M
Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital, Weill Cornell Medical College, Houston, TX, USA.
Houston Methodist Gastroenterology Associates, 6550 Fannin St, SM 1201, Houston, TX, 77030, USA.
Curr Gastroenterol Rep. 2019 Jan 15;21(1):3. doi: 10.1007/s11894-019-0671-z.
To critically review recent (past 3 years) literature on the definition, diagnosis, and management of small intestinal bacterial overgrowth (SIBO).
While various series continue to illustrate the occurrence of SIBO in disease states where well-known risk factors for its occurrence are present (hypochlorhydria, disorders of intestinal structure or motor function, pancreatic insufficiency, and chronic liver disease, for example), the current challenge is in defining the limits of SIBO. Is SIBO truly common among those with "functional" gastrointestinal symptoms where there is no evidence of maldigestion or malabsorption; the original hallmarks of SIBO? Our attempts to address this question continue to be hampered by the limitations of our diagnostic tool kit. There is hope-the application of modern molecular techniques to the study of the small intestinal microbiome, together with some innovative sampling techniques, such as real-time intestinal gas sampling, may soon allow us to truly define the spectrum of SIBO. SIBO, once removed from its original confines as a cause of malabsorption syndrome, has proven to be an elusive and moving target. Only the most rigorous studies employing validated methodologies will finally corral this mysterious entity.
对近期（过去3年）关于小肠细菌过度生长（SIBO）的定义、诊断和管理的文献进行批判性综述。
尽管各种系列研究不断表明，在存在SIBO发生的知名危险因素的疾病状态中会出现SIBO（例如胃酸过少、肠道结构或运动功能障碍、胰腺功能不全和慢性肝病），但目前的挑战在于界定SIBO的范围。在没有消化不良或吸收不良证据的“功能性”胃肠道症状患者中，SIBO是否真的常见；SIBO最初的特征？我们解决这个问题的尝试仍然受到诊断工具包局限性的阻碍。还是有希望的——将现代分子技术应用于小肠微生物群的研究，再加上一些创新的采样技术，如实时光肠道气体采样，可能很快就能让我们真正界定SIBO的范围。SIBO一旦脱离其作为吸收不良综合征病因的最初范畴，就已证明是一个难以捉摸且不断变化的目标。只有采用经过验证方法的最严格研究，最终才能掌控这个神秘的实体。
