1921
Volume 100, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Small intestine bacterial overgrowth (SIBO) is prevalent among children living in low-income settings, leading to impaired growth and development. The aim of this study was to assess linear and ponderal growth parameters between malnourished SIBO-positive and SIBO-negative children aged 12–18 months who prospectively underwent a nutritional intervention. A glucose hydrogen breath test to detect SIBO was performed in 194 stunted (length-for-age score [LAZ] < −2 standard deviations) or at-risk of stunting (LAZ score between < −1 and −2 standard deviations) children. Participants received nutritional supplementation (egg and milk) in addition to their regular family meals 6 days per week for 90 days. Small intestine bacterial overgrowth was defined as a ≥ 12-ppm rise in breath hydrogen over the patient’s baseline during the 3-hour test. Small intestine bacterial overgrowth status before intervention was forced into a multivariable linear regression model to examine its effects on anthropometric changes in response to the intervention. Sociodemographic data at enrollment was analyzed through multivariable logistic regression in an attempt to predict SIBO positivity. Overall, 14.9% (29/194) children were diagnosed with SIBO before the nutritional intervention. No statistically significant difference was observed among SIBO-positive and SIBO-negative groups in terms of their response to the nutritional intervention (SIBO-positive coefficient [95% confidence interval (CI)], -value for ∆length-for-age Z score −0.003 [−0.14, 0.13], 0.96; ∆weight-for-age score −0.05 [−0.20, 0.09], 0.46; and ∆weight-for-length score −0.10 [−0.31, 0.10], 0.33). This study demonstrated that a noteworthy proportion of malnourished children living in a disadvantaged urban community were SIBO positive; however, it failed to reveal an association between SIBO status and response to nutritional intervention.

[open-access] 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.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.18-0759
2018-11-26
2019-11-22
Loading full text...

Full text loading...

/deliver/fulltext/14761645/100/1/tpmd180759.html?itemId=/content/journals/10.4269/ajtmh.18-0759&mimeType=html&fmt=ahah

References

  1. Sieczkowska A, Landowski P, Kaminska B, Lifschitz C, , 2016. Small bowel bacterial overgrowth in children. J Pediatr Gastroenterol Nutr 62: 196207. [Google Scholar]
  2. dos Reis JC, de Morais MB, Oliva CA, Fagundes-Neto U, , 2007. Breath hydrogen test in the diagnosis of environmental enteropathy in children living in an urban slum. Dig Dis Sci 52: 12531258. [Google Scholar]
  3. Pereira SP, Khin Maung U, Bolin TD, Duncombe VM, Nyunt Nyunt W, Myo K, Linklater JM, , 1991. A pattern of breath hydrogen excretion suggesting small bowel bacterial overgrowth in Burmese village children. J Pediatr Gastroenterol Nutr 13: 3238. [Google Scholar]
  4. Mello CS, Tahan S, Melli LC, Rodrigues MS, de Mello RM, Scaletsky IC, de Morais MB, , 2012. Methane production and small intestinal bacterial overgrowth in children living in a slum. World J Gastroenterol 18: 59325939. [Google Scholar]
  5. Donowitz JR, 2016. Small intestine bacterial overgrowth and environmental enteropathy in Bangladeshi children. MBio 7: e02102e02115. [Google Scholar]
  6. Ahmed T, 2014. The MAL-ED cohort study in Mirpur, Bangladesh. Clin Infect Dis 59 (Suppl 4): S280S286. [Google Scholar]
  7. Mahfuz M, 2017. Bangladesh environmental enteric dysfunction (BEED) study: protocol for a community-based intervention study to validate non-invasive biomarkers of environmental enteric dysfunction. BMJ Open 7: e017768. [Google Scholar]
  8. Brandt LJ, Bernstein LH, Wagle A, , 1977. Production of vitamin B 12 analogues in patients with small-bowel bacterial overgrowth. Ann Intern Med 87: 546551. [Google Scholar]
  9. Brin MF, Fetell MR, Green PH, Kayden HJ, Hays AP, Behrens MM, Baker H, , 1985. Blind loop syndrome, vitamin E malabsorption, and spinocerebellar degeneration. Neurology 35: 338342. [Google Scholar]
  10. Di Stefano M, Veneto G, Malservisi S, Corazza GR, , 2001. Small intestine bacterial overgrowth and metabolic bone disease. Dig Dis Sci 46: 10771082. [Google Scholar]
  11. Lakhani SV, Shah HN, Alexander K, Finelli FC, Kirkpatrick JR, Koch TR, , 2008. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients. Nutr Res 28: 293298. [Google Scholar]
  12. Schjonsby H, , 1977. Osteomalacia in the stagnant loop syndrome. Acta Med Scand Suppl 603: 3941. [Google Scholar]
  13. Khin Maung U, Pereira SP, Bolin TD, Duncombe VM, Myo K, Nyunt Nyunt W, Linklater JM, , 1990. Malabsorption of carbohydrate from rice and child growth: a longitudinal study with the breath-hydrogen test in Burmese village children. Am J Clin Nutr 52: 348352. [Google Scholar]
  14. Omoike IU, Abiodun PO, , 1989. Upper small intestinal microflora in diarrhea and malnutrition in Nigerian children. J Pediatr Gastroenterol Nutr 9: 314321. [Google Scholar]
  15. Khin Maung U, Bolin TD, Duncombe VM, Myo K, Nyunt Nyunt W, Pereira SP, Linklater JM, , 1992. Epidemiology of small bowel bacterial overgrowth and rice carbohydrate malabsorption in Burmese (Myanmar) village children. Am J Trop Med Hyg 47: 298304. [Google Scholar]
  16. Oriach CS, Robertson RC, Stanton C, Cryan JF, Dinan TG, , 2016. Food for thought: the role of nutrition in the microbiota-gut–brain axis. Clin Nutr Exp 6: 2538. [Google Scholar]
  17. De Filippo C, Cavalieri D, Di Paola M, Ramazzotti M, Poullet JB, Massart S, Collini S, Pieraccini G, Lionetti P, , 2010. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci USA 107: 1469114696. [Google Scholar]
  18. Marlow G, Ellett S, Ferguson IR, Zhu S, Karunasinghe N, Jesuthasan AC, Han DY, Fraser AG, Ferguson LR, , 2013. Transcriptomics to study the effect of a Mediterranean-inspired diet on inflammation in Crohn’s disease patients. Hum Genomics 7: 24. [Google Scholar]
  19. Gasbarrini A, 1st Rome H2-Breath Testing Consensus Conference Working Group , 2009. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference. Aliment Pharmacol Ther 29 (Suppl 1): 149. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.18-0759
Loading
/content/journals/10.4269/ajtmh.18-0759
Loading

Data & Media loading...

  • Received : 17 Sep 2018
  • Accepted : 17 Oct 2018
  • Published online : 26 Nov 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error