medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-9-70-74medsovet-1387Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYЧто мы знаем о синдроме избыточного бактериального ростаWHAT WE KNOW ABOUT EXCESSIVE BACTERIAL GROWTH SYNDROMEОСИПЕНКОМ. Ф.OSIPENKOM. F.

д.м.н., профессор

MD, Prof.

СКАЛИНСКАЯМ. И.SKALINSKAYAM. I.

к.м.н.

PhD in medicine

КУЛЫГИНАЮ. А.KULYGINAY. A.ХОЛИНС. И.KHOLINS. I.

к.м.н.

PhD in medicine

КРАСНЕРЯ. А.KRASNERY. A.Новосибирский государственный медицинский университет Минздрава РоссииРоссияNovosibirsk State Medical University of the Ministry of Health of RussiaRussian Federation201630122016097074Copyright © ОСИПЕНКО М.Ф., СКАЛИНСКАЯ М.И., КУЛЫГИНА Ю.А., ХОЛИН С.И., КРАСНЕР Я.А., 20162016ОСИПЕНКО М.Ф., СКАЛИНСКАЯ М.И., КУЛЫГИНА Ю.А., ХОЛИН С.И., КРАСНЕР Я.А.OSIPENKO M.F., SKALINSKAYA M.I., KULYGINA Y.A., KHOLIN S.I., KRASNER Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1387

Синдром избыточного бактериального роста (СИБР) довольно сложная, важная и активно изучаемая на данный момент проблема в клинической практике. В настоящее время нет четких рекомендаций в отношении диагностики СИБР. В последнее время все чаще используют дыхательные тесты, которые, однако, обладают различной специфичностью и чувствительностью. Диагностировать и проводить дифференциальную диагностику СИБР непросто, но вместе с тем и важно, поскольку это позволяет оптимизировать лечение больного.

The excessive bacterial growth syndrome (EBGS) is a rather complicated, important and currently actively studied problem in the clinical practice. Currently there are no strict recommendations in respect of EBGS diagnostics. Respiratory tests have been extensively used of late that have various specificity and sensitivity. It’s difficult to diagnose and to conduct differential diagnostics of EBGS but important as well as it allows optimization of the patient therapy.

синдром избыточного бактериального ростадыхательные тестылечениеexcessive bacterial growth syndromediagnostic teststherapyReferencesCamp JG, Kanther M, Semova I, Rawls JF. Patterns and scales in gastrointestinal microbial ecology. Gastroenterology, 2009 May, 136(6): 1989-2002.Camp JG, Kanther M, Semova I, Rawls JF. Patterns and scales in gastrointestinal microbial ecology. Gastroenterology, 2009 May, 136(6): 1989-2002.Toskes PP, Kumar A. Enteric bacterial flora and bacterial overgrowth syndrome. In: Feldman M, Scharschmidt BF, Sleisenger MH, editors. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 6th ed. Philadelphia: WB Saunders; 1998: 1523-1535.Toskes PP, Kumar A. Enteric bacterial flora and bacterial overgrowth syndrome. In: Feldman M, Scharschmidt BF, Sleisenger MH, editors. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 6th ed. Philadelphia: WB Saunders; 1998: 1523-1535.Swidsinski A, Loening-Baucke V. Spatial organization of intestinal microbiota in health and disease. UpToDate on line, 18.1. Wellesley, 2010. Available from : http://www.uptodate.com.Swidsinski A, Loening-Baucke V. Spatial organization of intestinal microbiota in health and disease. UpToDate on line, 18.1. Wellesley, 2010. Available from : http://www.uptodate.com.Bouhnik Y, Alain S, Attar A, Flourié B, Raskine L, Sanson-Le Pors MJ et al. Bacterial populations contaminating the upper gut in patients with small intestinal bacterial overgrowth syndrome. Am J Gastroenterol, 1999 May, 94(5): 1327-31.Bouhnik Y, Alain S, Attar A, Flourié B, Raskine L, Sanson-Le Pors MJ et al. Bacterial populations contaminating the upper gut in patients with small intestinal bacterial overgrowth syndrome. Am J Gastroenterol, 1999 May, 94(5): 1327-31.Scarpellini E, Giorgio V, Gabrielli M, Lauritano EC, Pantanella A, Fundarò C et al Prevalence of small intestinal bacterial overgrowth in children with irritable bowel syndrome: a casecontrol study. J Pediatr, 2009, 155: 416-420.Scarpellini E, Giorgio V, Gabrielli M, Lauritano EC, Pantanella A, Fundarò C et al Prevalence of small intestinal bacterial overgrowth in children with irritable bowel syndrome: a casecontrol study. J Pediatr, 2009, 155: 416-420.Sabaté JM, Jouët P, Harnois F, Mechler C, Msika S, Grossin M, Coffin B. High prevalence of small intestinal bacterial overgrowth in patients with morbid obesity: a contributor to severe hepatic steatosis. Obes Surg., 2008, 18: 371-377.Sabaté JM, Jouët P, Harnois F, Mechler C, Msika S, Grossin M, Coffin B. High prevalence of small intestinal bacterial overgrowth in patients with morbid obesity: a contributor to severe hepatic steatosis. Obes Surg., 2008, 18: 371-377.Vanderhoof JA, Young RJ. Etiology and pathogenesis of bacterial overgrowth. Clinical manifestations and diagnosis of bacterial overgrowth. Treatment of bacterial overgrowth. UpToDate online, vol 18.1, Wellesley, 2010. Available from: http://www.uptodate.com.Vanderhoof JA, Young RJ. Etiology and pathogenesis of bacterial overgrowth. Clinical manifestations and diagnosis of bacterial overgrowth. Treatment of bacterial overgrowth. UpToDate online, vol 18.1, Wellesley, 2010. Available from: http://www.uptodate.com.Stotzer PO, Brandberg A, Kilander A.F. Diagnosis of small intestinal bacterial overgrowth in clinical praxis: a comparison of the culture of small bowel aspirate, duodenal biopsies and gastric aspirate. Hepatogastroenterology, 1998, 45: 1018-1022.Stotzer PO, Brandberg A, Kilander A.F. Diagnosis of small intestinal bacterial overgrowth in clinical praxis: a comparison of the culture of small bowel aspirate, duodenal biopsies and gastric aspirate. Hepatogastroenterology, 1998, 45: 1018-1022.Rubio-TA, Barton S, Rosenblatt JE et al. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol, 2009, 43: 157-161.Rubio-TA, Barton S, Rosenblatt JE et al. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol, 2009, 43: 157-161.Paik CN, Choi MG, Lim CH et al. The role of small intestinal bacterial overgrowth in postgastrectomy patients. Neurogastroenterol Motil, 2011, 23: 191-196.Paik CN, Choi MG, Lim CH et al. The role of small intestinal bacterial overgrowth in postgastrectomy patients. Neurogastroenterol Motil, 2011, 23: 191-196.Pyleris E, Giamarellos-Bourboulis EJ, Tzivras D et al. The prevalence of overgrowth by aerobic bacteria in the small intestine by small bowel culture: relationship with irritable bowel syndrome. Dig Dis Sci., 2012, 57: 1321-1329.Pyleris E, Giamarellos-Bourboulis EJ, Tzivras D et al. The prevalence of overgrowth by aerobic bacteria in the small intestine by small bowel culture: relationship with irritable bowel syndrome. Dig Dis Sci., 2012, 57: 1321-1329.Marie I, Ducrotte P, Denis, P et al. Small intestinal bacterial overgrowth in systemic sclerosis. Rheumatology (Oxford), 2009, 48: 1314-1319.Marie I, Ducrotte P, Denis, P et al. Small intestinal bacterial overgrowth in systemic sclerosis. Rheumatology (Oxford), 2009, 48: 1314-1319.Ebert EC. The thyroid and the gut. J Clin Gastroenterol, 2010, 44: 402-406.Ebert EC. The thyroid and the gut. J Clin Gastroenterol, 2010, 44: 402-406.Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA, 2004, 292: 852-858.Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA, 2004, 292: 852-858.Lupascu A, Gabrielli M, Lauritano EC, Scarpellini E, Santoliquido A, Cammarota G et al. Hydrogen glucose breath test to detect small intestinal bacterial overgrowth: a prevalence case-control study in irritable bowel syndrome. Aliment Pharmacol Ther, 2005, 22: 1157- 1160.Lupascu A, Gabrielli M, Lauritano EC, Scarpellini E, Santoliquido A, Cammarota G et al. Hydrogen glucose breath test to detect small intestinal bacterial overgrowth: a prevalence case-control study in irritable bowel syndrome. Aliment Pharmacol Ther, 2005, 22: 1157- 1160.Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol, 2000, 95: 3503-3506.Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol, 2000, 95: 3503-3506.Rubio-Tapia A, Barton SH, Rosenblatt JE, Murray JA. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol, 2009, 43: 157-161.Rubio-Tapia A, Barton SH, Rosenblatt JE, Murray JA. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol, 2009, 43: 157-161.Pande C, Kumar A, Sarin SK. Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease. Aliment Pharmacol Ther, 2009, 29: 1273-1281.Pande C, Kumar A, Sarin SK. Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease. Aliment Pharmacol Ther, 2009, 29: 1273-1281.Runyon BA. Pathogenesis of spontaneous bacterial peritonitis. UpToDate on line, 18.1. Wellesley, 2010.Runyon BA. Pathogenesis of spontaneous bacterial peritonitis. UpToDate on line, 18.1. Wellesley, 2010.Almeida JA, Kim R, Stoita A, McIver CJ, Kurtovic J, Riordan SM. Lactose malabsorption in the elderly: role of small intestinal bacterial overgrowth. Scand J Gastroenterol, 2008, 43: 146-154.Almeida JA, Kim R, Stoita A, McIver CJ, Kurtovic J, Riordan SM. Lactose malabsorption in the elderly: role of small intestinal bacterial overgrowth. Scand J Gastroenterol, 2008, 43: 146-154.Scarpellini E, Gabrielli M, Za T, Lauritano EC, Santoliquido A, Rossi E, Ojetti V, Cammarota G, De Stefano V, Gasbarrini A. The interactionbetween small intestinal bacterial overgrowth and warfarin treatment. Am J Gastroenterol. 2009, 104: 2364-2365.Scarpellini E, Gabrielli M, Za T, Lauritano EC, Santoliquido A, Rossi E, Ojetti V, Cammarota G, De Stefano V, Gasbarrini A. The interactionbetween small intestinal bacterial overgrowth and warfarin treatment. Am J Gastroenterol. 2009, 104: 2364-2365.Rutgeerts P, Ghoos Y, Vantrappen G, Eyssen H. Ileal dysfunction and bacterial overgrowth in patients with Crohn’s disease. Eur J Clin Invest, 1981, 11: 199-206.Rutgeerts P, Ghoos Y, Vantrappen G, Eyssen H. Ileal dysfunction and bacterial overgrowth in patients with Crohn’s disease. Eur J Clin Invest, 1981, 11: 199-206.Husebye E. The pathogenesis of gastrointestinal bacterial overgrowth. Chemotherapy, 2005, 51(Suppl 1): 1-22.Husebye E. The pathogenesis of gastrointestinal bacterial overgrowth. Chemotherapy, 2005, 51(Suppl 1): 1-22.Neut C, Bulois P, Desreumaux P, Membré JM, Lederman E, Gambiez Let al. Changes in the bacterial flora of the neoterminal ileum after ileocolonic resection for Crohn’s disease. Am J Gastroenterol, 2002, 97: 939-946.Neut C, Bulois P, Desreumaux P, Membré JM, Lederman E, Gambiez Let al. Changes in the bacterial flora of the neoterminal ileum after ileocolonic resection for Crohn’s disease. Am J Gastroenterol, 2002, 97: 939-946.Klaus J, Spaniol U, Adler G, Mason RA, Reinshagen M, Tirpitz C. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn’s Disease. BMCKlaus J, Spaniol U, Adler G, Mason RA, Reinshagen M, Tirpitz C. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn’s Disease. BMCGastroenterol, 2009, 9: 61.Gastroenterol, 2009, 9: 61.Sánchez-Montes C, Ortiz V, Bastida G, Rodríguez E, Yago M, Beltrán B et al. Small intestinal bacterial overgrowth in inactive Crohn’s disease: influence of thiopurine and biological treatment. World J Gastroenterol, 2014 Oct 14, 20(38): 13999-4003.Sánchez-Montes C, Ortiz V, Bastida G, Rodríguez E, Yago M, Beltrán B et al. Small intestinal bacterial overgrowth in inactive Crohn’s disease: influence of thiopurine and biological treatment. World J Gastroenterol, 2014 Oct 14, 20(38): 13999-4003.Quigley EM. Bacteria: a new player in gastrointestinal motility disorders-infections, bacterial overgrowth, and probiotics. Gastroenterol. Clin. North Am., 2007, 36: 735-748.Quigley EM. Bacteria: a new player in gastrointestinal motility disorders-infections, bacterial overgrowth, and probiotics. Gastroenterol. Clin. North Am., 2007, 36: 735-748.Chen SJ, Liu XW, Liu JP, Yang XY, Lu FG. Ulcerative colitis as a polymicrobial infection characterized by sustained broken mucus barrier. World J Gastroenterol, 2014 July 28, 20(28): 9468-9475.Chen SJ, Liu XW, Liu JP, Yang XY, Lu FG. Ulcerative colitis as a polymicrobial infection characterized by sustained broken mucus barrier. World J Gastroenterol, 2014 July 28, 20(28): 9468-9475.Khoshini R, Dai SC, Lezcano S et al. A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Dig Dis Sci, 2008, 53: 1443-1454.Khoshini R, Dai SC, Lezcano S et al. A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Dig Dis Sci, 2008, 53: 1443-1454.Bures J, Cyrany J, Kohoutova D et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol, 2010, 16: 2978-2990.Bures J, Cyrany J, Kohoutova D et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol, 2010, 16: 2978-2990.Braden B. Methods and functions: breath tests. Best Pract Res Clin Gastroenterol, 2009, 23: 337-352.Braden B. Methods and functions: breath tests. Best Pract Res Clin Gastroenterol, 2009, 23: 337-352.Gasbarrini A, Corazza GR, Gasbarrini G et al. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther, 2009, 29: 1-49.Gasbarrini A, Corazza GR, Gasbarrini G et al. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther, 2009, 29: 1-49.Donald IP, Kitchingmam G, Donald F et al. The diagnosis of small bowel bacterial overgrowth in elderly patients. J Am Geriatr Soc, 1992, 40: 692-696.Donald IP, Kitchingmam G, Donald F et al. The diagnosis of small bowel bacterial overgrowth in elderly patients. J Am Geriatr Soc, 1992, 40: 692-696.Hope H, Skar V, Sandstad O et al. Small intestinal malabsorption in chronic alcoholism: a retrospective study of alcoholic patients by the (1) (4)C-D-xylose breath test. Scand J Gastroenterol, 2012, 47: 428-434.Hope H, Skar V, Sandstad O et al. Small intestinal malabsorption in chronic alcoholism: a retrospective study of alcoholic patients by the (1) (4)C-D-xylose breath test. Scand J Gastroenterol, 2012, 47: 428-434.Stotzer PO, Kilander AF. Comparison of the 1-gram (14)C-D-xylose breath test and the 50-gram hydrogen glucose breath test for diagnosis of small intestinal bacterial overgrowth. Digestion, 2000, 61: 165-171.Stotzer PO, Kilander AF. Comparison of the 1-gram (14)C-D-xylose breath test and the 50-gram hydrogen glucose breath test for diagnosis of small intestinal bacterial overgrowth. Digestion, 2000, 61: 165-171.Sahakian AB, Jee SR. Pimentel M. Methane and the gastrointestinal tract. Dig Dis Sci, 2010, 55: 2135-2143.Sahakian AB, Jee SR. Pimentel M. Methane and the gastrointestinal tract. Dig Dis Sci, 2010, 55: 2135-2143.Levitt MD, Furne JK, Kuskowski M et al. Stability of human methanogenic flora over 35 years and a review of insights obtained from breath methane measurements. Clin Gastroenterol Hepatol, 2006, 4: 123-129.Levitt MD, Furne JK, Kuskowski M et al. Stability of human methanogenic flora over 35 years and a review of insights obtained from breath methane measurements. Clin Gastroenterol Hepatol, 2006, 4: 123-129.Ghoshal UC. How to interpret hydrogen breath tests. J Neurogastroenterol Motil, 2011, 17: 312-317.Ghoshal UC. How to interpret hydrogen breath tests. J Neurogastroenterol Motil, 2011, 17: 312-317.Yu D, Cheeseman F, Vanner S. Combined orocaecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS. Gut, 2011, 60: 334-340.Yu D, Cheeseman F, Vanner S. Combined orocaecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS. Gut, 2011, 60: 334-340.Ghoshal UC, Ghoshal U, Das K et al. Utility of hydrogen breath tests in diagnosis of small intestinal bacterial overgrowth in malabsorption syndrome and its relationship with oro- cecal transit time. Indian J Gastroenterol, 2006, 25: 6-10.Ghoshal UC, Ghoshal U, Das K et al. Utility of hydrogen breath tests in diagnosis of small intestinal bacterial overgrowth in malabsorption syndrome and its relationship with oro- cecal transit time. Indian J Gastroenterol, 2006, 25: 6-10.Castiglione F, Rispo A, Di Girolamo E, Cozzolino A, Manguso F, Grassia R, Mazzacca G. Antibiotic treatment of small bowel bacterial overgrowth in patients with Crohn’s disease. Alimentary Pharmacology & Therapeutics, 2003 December, 18(Issue 11-12): 1107-1112.Castiglione F, Rispo A, Di Girolamo E, Cozzolino A, Manguso F, Grassia R, Mazzacca G. Antibiotic treatment of small bowel bacterial overgrowth in patients with Crohn’s disease. Alimentary Pharmacology & Therapeutics, 2003 December, 18(Issue 11-12): 1107-1112.Kopacova M, Bures J, Cyrany J et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol, 2010, 16(24): 2978-2990.Kopacova M, Bures J, Cyrany J et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol, 2010, 16(24): 2978-2990.Boltin D, Perets TT, Shporn E, Aizic S, Levy S, Niv Y et al. Rifaximin for small intestinal bacterial overgrowth in patients without irritable bowel syndrome. Ann Clin Microbiol Antimicrob, 2014, 13: 49.Boltin D, Perets TT, Shporn E, Aizic S, Levy S, Niv Y et al. Rifaximin for small intestinal bacterial overgrowth in patients without irritable bowel syndrome. Ann Clin Microbiol Antimicrob, 2014, 13: 49.

The authors declare that there are no conflicts of interest present.