title: Rational Use of Antibiotics in the Treatment of Functional Bowel Disorders.
abstract: Functional gastrointestinal symptoms such us bloating, fullness, flatulence, diarrhea, and constipation due to irritable bowel syndrome (IBS) were recently attributed to small bowel bacterial overgrowth, a condition depending on the presence of an increased number of bacteria in the small bowel. However, the methodology used to describe this association may be harshly criticized, since it has already been shown to be quite inaccurate. As a result an inappropriate use of antibiotics was consequently generated. In fact, antibiotics could be effective in the treatment of functional complaints, but only in a limited subgroup of patients, characterized by an increase of fermentation at colonic level. In this review, we have examined the papers suggesting a pathophysiological link between IBS and small bowel bacterial overgrowth, underlining its inappropriateness, and put forth our personal view on the rationale for antibiotic use in IBS.
authors.affiliation: Department of Medicine, University of Pavia, Foundation IRCCS S.Matteo Hospital, P.le C. Golgi 2, Pavia, Italy.
authors.forename: Michele Di
authors.initials: MD
authors.lastname: Stefano
authors.affiliation: Department of Medicine, University of Pavia, Foundation IRCCS S.Matteo Hospital, P.le C. Golgi 2, Pavia, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Fasulo
authors.affiliation: Department of Medicine, University of Pavia, Foundation IRCCS S.Matteo Hospital, P.le C. Golgi 2, Pavia, Italy. gr.corazza@smatteo.pv.it.
authors.forename: Gino Roberto
authors.initials: GR
authors.lastname: Corazza
keywords: functional bowel disorders; gas-related symptoms; irritable bowel syndrome; rifaximin; small intestine bacterial overgrowth