Interrelation of irritable bowel syndrome and bacterial overgrowth: is there any?

Abstract

The aim of review. To estimate possible interrelation between bacterial overgrowth syndromes in the small intestine (BOS) and irritable bowel syndrome (IBS).Key points. BOS and IBS are extremely common syndromes, that contributes to their casual coexistence within same patient from epidemiological point of view. Clinical symptoms of BOS and IBS include meteorism, abdominal pain and disorders of defecation, that are difficult, at first sight, for differential diagnostics. From positions of pathophysiology it is possible to believe, that the IBS causes background for development of BOS, on the contrary, BOS increases risk of IBS development. Unfortunately, despite of huge quantity of studies, there is lack of convincing evidence to this for the present time. The evidential base is generated according to the studies showing high frequency of pathological breath tests in patients with IBS in comparison to healthy patients, however at IBS the rapid intestinal transit can promote false-positive results of breath tests. Other portion of evidential data is based on empirical application of nonabsorbable antibiotics that results in reduc tion of IBS symptoms. Failure to cure IBS by enteroantiseptic drugs requires necessity of search for new ways of treatment, including agents with enterosorptive action, capable to reduce BOS, velocity of intestinal transit and manifestations of IBS.

Keywords

• bacterial overgrowth syndrome in the small intestine
• irritable bowel syndrome
• treatment
• diosmectite