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Bilophilia, a hydrogen-sulfide-producing species, may likely be involved in the pathogenesis of hydrogen sulfide SIBO. Other studies showed that a reduction in FODMAP foods can significantly increase saccharolytic Bacteroides, Porphyromonadaceae and nonsaccharolytic taxon Bilophilia.
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Contrary to those studies, one paper found an inverse correlation, suggesting an increase in the quantity of Bifidobacterium and Lactobacillus however, this was following a low FODMAP and gluten-free diet. Nine authors proposed that the implementation of a low-FODMAP diet for 4 to 9 weeks may adversely decrease the abundance of Actinobacteria, especially beneficial Bifidobacterium, while the coadministration of a probiotic and prebiotic (fructo-oligosaccharides (FOSs), but not B-galactooligosaccharides (B-GOSs)) with the low-FODMAP diet may reverse these changes. Three studies investigated the relationship between probiotics or prebiotics in combination with the low-FODMAP diet on the gut microbiota. None of the studies evaluated the impact of this diet in SIBO patients. The majority of papers compared the low-FODMAP diet in IBS patients to traditional dietary recommendations, habitual diets or a high-FODMAP diet. Results and DiscussionĪltogether, twelve studies identified potential connections between a low-FODMAP diet and the microbiota profile, which are presented in Table 1. Ultimately, the review was limited to studies conducted in patients with SIBO, IBS and functional gastrointestinal disorders (FGIDs) and healthy people. Studies with results on inflammatory bowel disease, ulcerative colitis, colon cancer, colorectal cancer or celiac disease were also excluded. Studies based on children, pregnant women, animals, in vitro experiments, poliprobiotic treatments or studies reported in non-English languages were excluded. Conference proceedings, abstracts and meta-analyses were not included. The abstracts and titles of relevant articles were screened and only full-length papers with quantitative statistical analyses were included in this narrative review.
#SMALL BOWEL BACTERIAL OVERGROWTH TREATMENT TRIAL#
The search strategy included the following terms: (low FODMAP OR high FODMAP)AND (clinical trial OR randomized controlled trial OR cross-sectional study OR crossover study OR retrospective study OR intervention study) AND (IBS OR irritable bowel syndrome) AND (SIBO OR small intestinal bacterial overgrowth) AND (probiotic OR monoprobiotic OR bacterial strain) AND (fiber OR soluble fiber OR psyllium OR inulin OR phgg) AND (mmc OR migrating motor complex) AND (mindful eating or mindfulness training). Future research is needed to characterize a specific diet for the treatment of SIBO.Ī comprehensive search of PubMed, ScienceDirect and Google Scholar was conducted from 2012 to 2022 to identify suitable literature. Based on currently available literature, the potential efficacy of the IBS diet in SIBO is largely hypothetical. Therefore, optimal dietary patterns play a key role in the treatment of SIBO. Targeted probiotic therapy may also increase the effectiveness of antibiotic treatment and regulate bowel movements. Supplementation with soluble fiber can lessen the symptoms in IBS and SIBO. A low FODMAP diet proposed for IBS may promote a negative shift in the gut microbiota and deepen the existing state of dysbiosis in SIBO patients.
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Recent studies indicate that dietary manipulation may have a role in alleviating SIBO gastrointestinal symptoms. A narrative literature review was carried out using databases, including PubMed, ScienceDirect and Google Scholar. The objective of this study is to determine whether the current recommendations regarding nutrition in IBS are suitable for patients with SIBO. However, focusing only on the antimicrobial effects without taking care to improve lifestyle factors, especially dietary patterns, may predispose patients to intestinal microbiota dysfunction. The eradication of bacterial overgrowth with antibiotics is the first-line treatment. Small intestinal bacterial overgrowth (SIBO) is highly prevalent in irritable bowel syndrome (IBS).