[Small intestine bacterial overgrowth: six case reports and literature review].
BACKGROUND
Small intestinal bacterial overgrowth syndrome (SIBOS) has various clinical and biological presentations. Six observations are described in this review which is aimed at reporting recent data on SIBOS and proposing diagnosis and therapeutic attitudes.


BACKGROUND
Chronic diarrhea, malabsorption syndrome and exsudative enteropathy are the main criteria of diagnosis. Breath hydrogen testing is commonly performed to confirm diagnosis, with a 78% sensitivity and a 89% specificity. The aim of therapy is reparation of malabsorption consequences, reduction of intestinal bacterial overgrowth, and surgical correction of intestinal stasis. In the absence of consensus, norfloxacin or amoxicillin-clavulinic acid (administered for a mean of 7 to 15 days) seem the more appropriate antibiotics. When possible, surgery represents the primary treatment of SIBOS recurrences.


CONCLUSIONS
Diagnosis of small intestinal bacterial overgrowth 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.
Karsenti
D
D
Service de clinique médicale hôpital du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris, France. karsenti@club-internet.fr
Bechade
D
D
Fallik
D
D
Bili
H
H
Desrame
J
J
Coutant
G
G
Algayres
J P
JP
Daly
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D001944:Breath Tests; D002908:Chronic Disease; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D007421:Intestine, Small / Q000382:microbiology* / Q000473:pathology; D008286:Malabsorption Syndromes / Q000209:etiology; D008297:Male; D008875:Middle Aged
D000900:Anti-Bacterial Agents
Colonisation bactérienne chronique de l'intestin grêle: présentation de six observations et mise au point.