Small intestinal bacterial overgrowth syndrome: six case reports and literature review

Introduction. - Small intestinal bacterial overgrowth syndrome (SIBOS) has various clinical and biological presentations. Six observations are describ ed in this review which is aimed at reporting recent data on SIBOS and prop osing diagnosis and therapeutic attitudes. Current knowledge and key points. - Chronic diarrhea, malabsorption syndrom e and exsudative enteropathy are the main criteria of diagnosis. Breath hyd rogen testing is commonly performed to confirm diagnosis, with a 78% sensit ivity and a 89% specificity. The aim of therapy is reparation of malabsorpt ion consequences, reduction of intestinal bacterial overgrowth, and surgica l correction of intestinal stasis. in the absence of consensus, norfloxacin or amoxicillin-clavulinic acid (administered for a mean of 7 to 15 days) s eem the more appropriate antibiotics. When possible, surgery represents the primary treatment of SIBOS recurrences. Future prospects and projects. - Diagnosis of small intestinal bacterial ov ergrowth syndrome must be evoked on the basis of either surgical or medical context, i.e., the existence of chronic diarrhea, malabsorption syndrome ( complete or not), and exsudative enteropathy. This review reports essential factors for diagnosis and treatment. (C) 2001 Editions scientifiques et me dicales Elsevier SAS.