Small Intestinal Bacterial Overgrowth in Children: A State-Of-The-Art Review

David Avelar Rodriguez, Paul Mac Daragh Ryan, Erick Manuel Toro Monjaraz, Jaime Alfonso Ramirez Mayans, Eamonn Martin Quigley

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Small intestinal bacterial overgrowth (SIBO) is a heterogenous and poorly understood entity characterised by an excessive growth of select microorganisms within the small intestine. This excessive bacterial biomass, in turn, disrupts host physiology in a myriad of ways, leading to gastrointestinal and non-gastrointestinal symptoms and complications. SIBO is a common cause of non-specific gastrointestinal symptoms in children, such as chronic abdominal pain, abdominal distention, diarrhoea, and flatulence, amongst others. In addition, it has recently been implicated in the pathophysiology of stunting, a disease that affects millions of children worldwide. Risk factors such as acid-suppressive therapies, alterations in gastrointestinal motility and anatomy, as well as impoverished conditions, have been shown to predispose children to SIBO. SIBO can be diagnosed via culture-dependant or culture-independent approaches. SIBO's epidemiology is limited due to the lack of uniformity and consensus of its diagnostic criteria, as well as the paucity of literature available. Antibiotics remain the first-line treatment option for SIBO, although emerging modalities such as probiotics and diet manipulation could also have a role. Herein, we present a state-of-the-art-review which aims to comprehensively outline the most current information on SIBO in children, with particular emphasis on the gut microbiota.

Original languageEnglish (US)
Article number363
JournalFrontiers in Pediatrics
StatePublished - Sep 4 2019


  • gut microbiota
  • proton pump inhibitors
  • small bowel bacterial overgrowth
  • small intestinal bacterial overgrowth
  • small intestine bacterial overgrowth
  • stunting

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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