Small intestinal bacterial overgrowth (SIBO) is a common, yet underrecognized, problem. Its prevalence is unknown because SIBO requires diagnostic testing. Although abdominal bloating, gas, distension, and diarrhea are common symptoms, they do not predict positive diagnosis. Predisposing factors include proton-pump inhibitors, opioids, gastric bypass, colectomy, and dysmotility. Small bowel aspirate/culture with growth of 10-10 cfu/mL is generally accepted as the "best diagnostic method," but it is invasive. Glucose or lactulose breath testing is noninvasive but an indirect method that requires further standardization and validation for SIBO. Treatment, usually with antibiotics, aims to provide symptom relief through eradication of bacteria in the small intestine. Limited numbers of controlled studies have shown systemic antibiotics (norfloxacin and metronidazole) to be efficacious. However, 15 studies have shown rifaximin, a nonsystemic antibiotic, to be effective against SIBO and well tolerated. Through improved awareness and scientific rigor, the SIBO landscape is poised for transformation.

中文翻译：

---

小肠细菌过度生长：临床特征和治疗管理。

小肠细菌过度生长（SIBO）是一个常见但尚未得到充分认识的问题。由于SIBO需要进行诊断测试，因此其发生率未知。尽管腹胀，腹胀，腹胀和腹泻是常见症状，但不能预测阳性诊断。诱发因素包括质子泵抑制剂，阿片类药物，胃绕道手术，结肠切除术和运动障碍。小肠抽吸物/培养物以10-10 cfu / mL的速度生长通常被认为是“最佳诊断方法”，但它是侵入性的。葡萄糖或乳果糖呼气试验是非侵入性的，但是是间接方法，需要对SIBO进行进一步的标准化和验证。通常用抗生素进行治疗的目的是通过消除小肠中的细菌来缓解症状。有限的对照研究表明，系统性抗生素（诺氟沙星和甲硝唑）有效。但是，有15项研究表明非系统性抗生素利福昔明对SIBO有效且耐受性良好。通过提高认识和科学严谨性，SIBO的前景已准备好进行转变。