小肠细菌过生长综合征与肠易激综合征关系研究

A STUDY ON THE RELATIONSHIP BETWEEN SMALL INTESTINAL BACTERIAL OVERGROWTH AND IRRITABLE BOWEL SYNDROME

目的 :了解小肠细菌过生长是否和肠易激综合征 (IBS)有关 ,益生素对肠易激综合征的疗效是否与控制小肠细菌过生长有关。方法 :92例符合罗马 标准的 IBS病人接受乳果糖氢呼气试验检测是否存在小肠细菌过生长。阳性者予以微生态制剂酪酸梭菌口服治疗 2周 ,停药 1周后复诊。比较治疗前后呼气试验的结果和肠易激综合征 8种症状的变化 ,包括腹胀、腹泻、腹痛、排便缓解、粘液便、排便不尽感、排便费力、便急。结果 :在 92例 IBS病人中有 6 3例存在小肠细菌过生长 ,占 6 8.5 %。有 5 1例治疗后复查了呼气试验 ,其中 2 6例转阴 ,2 5例仍阳性 ,转阴率为 5 1.0 %。转阴组病人腹痛、腹胀和腹泻 3种症状明显改善 ,未转阴病人则无一症状显著性改变。结论 :小肠细菌过生长与肠易激综合征有关 ;

Objective:Irritable bowel syndrome is the most common gastrointestinal diagnosis. The symptoms of irritable bowel syndrome are similar to those of small intestinal bacterial overgrowth.The purpose of this study was to test whether overgrowth is associated with irritable bowel syndrome and whether the effects of probiotic on the irritable bowel syndrome is related to the control of small intestinal bacterial overgrowth.Methods:Ninety-two subjects with irritable bowel syndrome met Rome Ⅱ criteria participated a lactulose hydrogen breath test for assessment of small intestinal bacterial overgrowth.Those with positive breath test were treated with Clostridiun butyricum for two weeks,and returned for follow-up breath test and symptoms one week after treatment.Symptoms assessed were abdominal pain,bloating,diarrhea,defecation relief,mucous,sensation of incomplete evacuation,straining,and urgency.Results:Of 92 irritable bowel syndrome patients,63(68.5%)had small intestinal bacterial overgrowth.Of these,51 had follow-up testing.Twenty-six(51.0%)of 51 follow-up subjects had eradication of small intestinal bacterial overgrowth.Comparison of those that eradicated to those that failed to eradicatde revealed an improvement in irritable bowel syndrome symptoms with abdominal pain,diarrhea and bloating being statisically significant.Conclusions:Small intestinal bacterial overgrowth is associated with irritable bowel syndrome.The effects of probiotic on the irritable bowel syndrome are related to the control of small intestinal bacterial overgrowth.