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Available online 4 October 2024
Small Intestinal Bacterial Overgrowth (SIBO), a clinically overdiagnosed entity?
Sobrecrecimiento bacteriano del intestino delgado (SIBO), ¿una entidad clínica sobrediagnosticada?
Jeannine Suárez Terána,
Corresponding author
jeanninesuarez@gmail.com

Corresponding author.
, Francisco Guarner Aguilarb
a Consulta Médica Privada, Barcelona, Spain
b Gastroenterología, Centro Médico Teknon, Barcelona, Spain
Received 07 December 2023. Accepted 23 March 2024
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Tables (5)
Table 1. Diagnosis of SIBO by microbiological analysis of duodenal/jejunal aspirate culture.
Table 2. Metagenomic analysis of small intestine microbiota in SIBO.
Table 3. Sensitivity and specificity of the glucose breath test for the diagnosis of SIBO.
Table 4. Sensitivity and specificity of the lactulose breath test for the diagnosis of SIBO.
Table 5. Sensitivity and specificity of the breath test for the diagnosis of SIBO.
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Abstract

Small intestinal bacterial overgrowth (SIBO) is a clinical entity recognised since ancient times; it represents the consequences of bacterial overgrowth in the small intestine associated with malabsorption. Recently, SIBO as a term has been popularized due to its high prevalence reported in various pathologies since the moment it is indirectly diagnosed with exhaled air tests.

In the present article, the results of duodenal/jejunal aspirate culture testing as a reference diagnostic method, as well as the characteristics of the small intestinal microbiota described by culture-dependent and culture-independent techniques in SIBO, and their comparison with exhaled air testing are presented to argue about its overdiagnosis.

Keywords:
Small intestinal bacterial overgrowth
Gut microbiota
Breath testing
Small intestinal dysbiosis
Microbiology
Resumen

El sobrecrecimiento bacteriano del intestino delgado (SIBO), es una entidad clínica reconocida desde tiempos remotos, que representaba las consecuencias del crecimiento bacteriano excesivo en el intestino delgado asociado a malabsorción. Recientemente, el término SIBO se ha popularizado debido a la alta prevalencia reportada en diversas patologías desde que se diagnostica de manera indirecta con las pruebas de aire espirado.

En el presente artículo, se exponen los resultados de las pruebas de cultivo del aspirado duodenal/yeyunal como método diagnóstico de referencia, las características de la microbiota del intestino delgado descritas mediante técnicas dependientes e independientes de cultivo en SIBO y su comparación con las pruebas de aire espirado, con el fin de argumentar acerca de su sobrediagnóstico.

Palabras clave:
Sobrecrecimiento bacteriano del intestino delgado
Microbiota intestinal
Test de aire espirado
Disbiosis del intestino delgado
Microbiología

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