Small-bowel bacterial overgrowth in children with chronic diarrhea, abdominal pain, or both
Small-bowel bacterial overgrowth in children with chronic diarrhea, abdominal pain, or both
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DOI：
10.1016/s0022-3476(96)70390-6
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发表时间：
1996-02-01
影响因子：
5.1
通讯作者：
Dupont, C
中科院分区：
文献类型：
--
作者：
deBoissieu, D;Chaussain, M;Dupont, C
目的：评估小肠细菌过度生长（SBBO）的频率作为一个大的队列的儿童慢性消化道症状的原因，使用葡萄糖呼吸氢试验（BHT）。设计：患者为53名儿童（年龄2个月至12岁）慢性腹泻，腹痛，或两者兼而有之。SBBO的诊断是通过口服葡萄糖负荷后呼气中H-2浓度的变化为10 ppm H-2或更高来定义的。BHT结果阳性的患者被纳入第1组，接受粘菌素和甲硝唑联合治疗10天; 1个月后进行第二次BHT。第2组包括BHT结果为阴性的患者。第3组（n = 15）是健康受试者的对照组，第4组（n = 6）是细菌学记录SBBO.Results的受试者的对照组：18例患者（34%）有阳性BHT结果和35个阴性结果。第1组和第4组以及第2组和第3组的BHT结果分别相当。第1组的空腹H-2水平高于第2组（p < 0.001）和第3组（p < 0.01）。在第1组中，儿童年龄小于第2组（1 +/- 1岁vs 3.9 +/- 3岁; p < 0.001），腹泻频繁（83%），但17%的患者仅腹痛。组1中恶臭粪便（p < 0.01）、粪便中粘液（p < 0.01）和肠胃气胀（p < 0.05）的发生率高于组2。抗生素治疗的儿童在第1组导致症状的迅速消失和正常化的BHT results.Conclusion：SBBO似乎是一个常见的原因，慢性消化道症状的儿童，特别是在2岁之前。BHT提供了一种简单、无创的检测方法，对儿童SBBO的识别有助于有效的治疗。
Objective: To evaluate the frequency of small-bowel bacterial overgrowth (SBBO) as a cause of chronic digestive symptoms in a large cohort of children, using the glucose breath hydrogen test (BHT).Design: Patients were 53 children (aged 2 months to 12 years) with chronic diarrhea, abdominal pain, or both. Diagnosis of SBBO was defined with a BHT by a change in H-2 concentration of 10 ppm H-2 or more in expired air after an oral glucose load. Patients with a positive BHT result were included in group 1 and treated with a combination of colistin and metronidazole for 10 days; a second BHT was performed 1 month later. Group 2 comprised patients with a negative BHT result. Group 3 (n = 15) was a control group of healthy subjects, and group 4 (n = 6) a comparison group of subjects with bacteriologically documented SBBO.Results: Eighteen patients (34%) had a positive BHT result and 35 a negative result. The BHT results were comparable in groups 1 and 4 and in groups 2 and 3, respectively. Fasting H-2 levels were higher in group 1 than in groups 2 (p < 0.001) and 3 (p < 0.01). In group 1, children were younger than in group 2 (1 +/- 1 year vs 3.9 +/- 3 years; p < 0.001) and diarrhea was frequent (83%), but 17% of patients had abdominal pain alone. Fetid stools (p < 0.01), mucus in stools (p < 0.01); and flatulence (p < 0.05) were more frequent in group 1 than in group 2. Antibiotic treatment of children in group 1 led to a rapid disappearance of symptoms and normalization of BHT results.Conclusion: SBBO appears to be a frequent cause of chronic digestive symptoms in children, especially before the age of 2 years. The BHT provides a simple and noninvasive method of detecting it. The recognition of SBBO in children leads to effective treatment.