![]() Furthermore, even after this invasive procedure to procure samples, the previous definition of SIBO by culture, >10 5 colony forming units per milliliter (CFU/per mL) of aspirate, was based on older studies in subjects with post-surgical anatomy with blind loop syndrome, rather than normal anatomy. Second, the ideal sampling location within the 20-foot length of the small bowel is subject to question. First, there is a need for validated techniques for sterile aspiration of small bowel fluid without contamination from oral microbiota. In the case of culture, there are many limitations. ![]() In their current forms, both tests provide only a narrow understanding of the composition of the small intestinal microbiome or its impact on the host. Traditionally, SIBO has been defined by two primary methods direct culture of small bowel aspirates, and indirect assessment using carbohydrate (e.g. Although SIBO may represent the most common microbiome perturbation in medicine, it was recently noted that the ‘spectrum of SIBO’ remains to be truly defined, in part due to the lack of understanding of the normal bacterial populations of the small intestine, and how these may be altered in disease states. SIBO is known to play important roles in a variety of conditions and disease states, including irritable bowel syndrome (IBS), fatty liver, inflammatory bowel disease, and many others, and associated symptoms include bloating, changes in bowel function and abdominal discomfort. Interest in SIBO has been fueled by the ever-increasing awareness of the human microbiome and its potential relationships to human health and disease. Small intestinal bacterial overgrowth (SIBO) is a condition defined by abnormal and excessive numbers of bacteria in the small bowel, usually associated with gastrointestinal (GI) symptoms such as bloating, excess of gas, abdominal discomfort, diarrhea, and weight loss. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: Data for this project are available at NCBI under BioProject ID PRJNA525828.įunding: RM received grants from The Monica Lester Charitable Trust and The Elias, Genevieve and Georgianna Atol Charitable Trust. Received: NovemAccepted: JPublished: July 9, 2020Ĭopyright: © 2020 Leite et al. ![]() PLoS ONE 15(7):Įditor: Simon Clegg, University of Lincoln, UNITED KINGDOM (2020) The duodenal microbiome is altered in small intestinal bacterial overgrowth. Future research may elucidate host-microbiome interactions underlying these symptoms in SIBO patients.Ĭitation: Leite G, Morales W, Weitsman S, Celly S, Parodi G, Mathur R, et al. non-SIBO subjects, coupled with an altered Proteobacterial profile that correlates with symptom severity. Duodenal samples from SIBO subjects had 4x10 3-fold higher counts than non-SIBO subjects when plated on MacConkey agar (P10 3 CFU/mL cutoff for the definition of SIBO, and also reveal specific overgrowth of Proteobacteria in SIBO vs. Using the recently-redefined cutoff for SIBO of >10 3 colony forming units per milliliter (CFU/mL), 42 SIBO and 98 non-SIBO subjects were identified. Therefore, we aimed to determine and compare the duodenal microbiome composition in SIBO and non-SIBO subjects, using duodenal aspirates from subjects undergoing standard-of-care esophagogastroduodenoscopy without colon preparation. ![]() Moreover, existing studies of microbiome alterations in SIBO have utilized stool samples, which are not representative of the entire gastrointestinal tract. ![]() Small intestinal bacterial overgrowth (SIBO) is highly prevalent and is associated with numerous gastrointestinal disorders, but the microbes involved remain poorly defined. ![]()
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