title: Prevalence of small intestinal bacterial overgrowth in children with irritable bowel syndrome: a case-control study.
abstract: OBJECTIVE
  To assess the prevalence of small intestinal bacterial overgrowth (SIBO) in children affected by irritable bowel syndrome (IBS).
  
  
  METHODS
  Consecutive children affected by IBS according to Rome II criteria (n = 43) were enrolled at the Gemelli Hospital, Catholic University of Rome. The control population (n = 56) consisted of healthy subjects without IBS symptoms, similar to patients for age, sex, and social background. All subjects underwent lactulose/methane breath test (LBT) to assess small intestinal bacterial overgrowth.
  
  
  RESULTS
  The prevalence of abnormal LBT result was significantly higher in patients with IBS (65%, 28/43) with respect to control subjects (7%, 4/56; OR 3.9, 95% CI 7.3-80.1, P < .00001). Patients with abnormal LBT showed a trend toward a worse visual analog scale score with respect to children with IBS without SIBO, but a significant statistical difference was observed only for bloating.
  
  
  CONCLUSIONS
  Results from this study suggest a significant epidemiologic association between SIBO and IBS in childhood. Placebo-controlled interventional studies with antibiotics used to treat bacterial overgrowth are warranted to clarify the real impact of the disease on IBS symptoms.
authors.affiliation: Internal Medicine Department, Catholic University of Sacred Heart, Gemelli Hospital, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Scarpellini
authors.forename: V
authors.initials: V
authors.lastname: Giorgio
authors.forename: M
authors.initials: M
authors.lastname: Gabrielli
authors.forename: E C
authors.initials: EC
authors.lastname: Lauritano
authors.forename: A
authors.initials: A
authors.lastname: Pantanella
authors.forename: C
authors.initials: C
authors.lastname: Fundarò
authors.forename: A
authors.initials: A
authors.lastname: Gasbarrini
mesh_terms: D000293:Adolescent; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism / Q000382:microbiology*; D001944:Breath Tests / Q000379:methods; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D007792:Lactulose / Q000378:metabolism; D008297:Male; D008697:Methane / Q000378:metabolism; D010147:Pain Measurement; D015995:Prevalence; D012384:Rome / Q000453:epidemiology; D012720:Severity of Illness Index
chemical_list: D007792:Lactulose; D008697:Methane