小肠细菌过度生长对炎症性肠病和其他胃肠道疾病患者的影响——一项三级单中心回顾性分析及文献综述
Impact of Small Intestinal Bacterial Overgrowth in Patients with Inflammatory Bowel Disease and Other Gastrointestinal Disorders-A Retrospective Analysis in a Tertiary Single Center and Review of the Literature.
作者信息
Wanzl Julia, Gröhl Katharina, Kafel Agnieszka, Nagl Sandra, Muzalyova Anna, Gölder Stefan Karl, Ebigbo Alanna, Messmann Helmut, Schnoy Elisabeth
机构信息
Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany.
出版信息
J Clin Med. 2023 Jan 25;12(3):935. doi: 10.3390/jcm12030935.
BACKGROUND
Small intestinal bacterial overgrowth (SIBO) is often found in patients with gut dysbiosis such as irritable bowel syndrome. Recently, the association of SIBO and inflammatory bowel disease (IBD) has been described in some cases. While clinical symptoms might be similar in IBD and SIBO, treatment is quite different for both diseases. Therefore, the differentiation between SIBO or a flare in IBD patients is key to optimizing treatment for these patients.
METHODS
We retrospectively investigated our patients with IBD receiving a glucose breath test for SIBO and correlated the results with the clinical symptoms (clinical remission or active disease).
RESULTS
128 patients with the diagnosis "colitis" were analyzed in our cohort. Fifty-three (41.4%) patients had Crohn's disease and 22 (17.2%) patients were suffering from ulcerative colitis. Seventy-four (57.8%) were female and 54 (42.2%) were male patients. A total of 18 (14.1%) patients had a positive testing for SIBO. Eleven (61.1%) cases were associated with CD patients and two (11.1%) with UC. IBD patients in clinical remission had a positive SIBO in six (19.4%) cases, while IBD patients with active disease were positive in nine (15.3%) cases. The proportion of positive SIBO in active IBD patients was higher; however, it did not reach significance. Older age was a risk factor for SIBO in patients with CD ( < 0.003).
CONCLUSIONS
In our study, we could show that an increased amount of SIBO was found in IBD patients and was especially more frequent in patients with CD than in those with UC. In UC patients, SIBO rates were not different to patients with other gastrointestinal diseases investigated (e.g., infectious colitis, collagenous colitis, or irritable bowel syndrome). In active IBD, positive SIBO was detected more often numerically compared to quiescent disease; however, due to the low number of patients included, it was not significant. However, older age was a significant risk factor for SIBO in patients with CD. SIBO is of clinical relevance in the vulnerable patient cohort with IBD, and its real prevalence and impact needs to be investigated in further and larger clinical trials.
背景
小肠细菌过度生长（SIBO）常见于肠道菌群失调患者，如肠易激综合征患者。最近，在一些病例中已描述了SIBO与炎症性肠病（IBD）的关联。虽然IBD和SIBO的临床症状可能相似，但两种疾病的治疗方法截然不同。因此，区分IBD患者是SIBO还是病情发作对于优化这些患者的治疗至关重要。
方法
我们回顾性研究了接受SIBO葡萄糖呼气试验的IBD患者，并将结果与临床症状（临床缓解或疾病活动）相关联。
结果
我们的队列分析了128例诊断为“结肠炎”的患者。53例（41.4%）患者患有克罗恩病，22例（17.2%）患者患有溃疡性结肠炎。74例（57.8%）为女性患者，54例（42.2%）为男性患者。共有18例（14.1%）患者SIBO检测呈阳性。11例（61.1%）病例与克罗恩病患者相关，2例（11.1%）与溃疡性结肠炎患者相关。临床缓解的IBD患者中有6例（19.4%）SIBO呈阳性，而疾病活动的IBD患者中有9例（15.3%）呈阳性。疾病活动的IBD患者中SIBO阳性比例更高；然而，未达到显著差异。年龄较大是克罗恩病患者发生SIBO的危险因素（<0.003）。
结论
在我们的研究中，我们发现IBD患者中SIBO数量增加，尤其是克罗恩病患者比溃疡性结肠炎患者更常见。在溃疡性结肠炎患者中，SIBO发生率与其他所研究的胃肠道疾病患者（如感染性结肠炎、胶原性结肠炎或肠易激综合征）无差异。与静止期疾病相比，在疾病活动的IBD中，SIBO阳性在数量上检测得更频繁；然而，由于纳入患者数量较少，差异不显著。然而，年龄较大是克罗恩病患者发生SIBO的重要危险因素。SIBO在IBD这一脆弱患者队列中具有临床相关性，其实际患病率和影响需要在进一步的大型临床试验中进行研究。
Zotero 插件