Irritable Bowel Syndrome dan Small Intestinal Bacterial Overgrowth: Serupa Tapi Tak Sama

Oleh :

dr.N Agung Prabowo, Sp.PD, M.Kes

Irritable bowel syndrome (IBS) dan small intestinal bacterial overgrowth (SIBO) diduga memiliki hubungan erat. Beberapa studi menunjukkan bahwa SIBO memiliki asosiasi dengan IBS, walaupun hubungan kausatif di antara keduanya masih belum diketahui pasti. Selain itu, IBS dan SIBO juga memiliki bermacam kemiripan dan gejala yang tumpang tindih.[1]

Sekilas Tentang Irritable Bowel Syndrome dan Small Intestinal Bacterial Overgrowth

Manifestasi klinis irritable bowel syndrome (IBS) utamanya adalah nyeri atau rasa tidak nyaman di perut, perut kembung, serta gangguan bentuk atau pengeluaran feses.[2-6] Semua gejala ini juga muncul pada small intestinal bacterial overgrowth (SIBO) sebagai akibat adanya peningkatan kolonisasi bakteri pada usus.[7]

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Aziz I, Törnblom H, Simrén M. Small intestinal bacterial overgrowth as a cause for irritable bowel syndrome: guilty or not guilty? Current Opinion in Gastroenterology. 2017 May;33(3):196–202.
2. Ghoshal UC. Irritable bowel syndrome and small intestinal bacterial overgrowth: Meaningful association or unnecessary hype. WJG. 2014;20(10):2482.
3. Liu ZJ, Wei H, Duan LP, Zhu SW, Zhang L, Wang K. Clinical features of irritable bowel syndrome with small intestinal bacterial overgrowth and a preliminary study of effectiveness of Rifaximin. 2016 Jun 28;96(24):1896-902.
4. Ghoshal UC, Srivastava D, Misra A, Ghoshal U. A proof-of-concept study showing antibiotics to be more effective in irritable bowel syndrome with than without small-intestinal bacterial overgrowth: a randomized, double-blind, placebo-controlled trial. European Journal of Gastroenterology & Hepatology. 2016 Mar;28(3):281–9.
5. Tuteja AK, Talley NJ, Stoddard GJ, Verne GN. Double-Blind Placebo-Controlled Study of Rifaximin and Lactulose Hydrogen Breath Test in Gulf War Veterans with Irritable Bowel Syndrome. Dig Dis Sci. 2019 Mar;64(3):838–45.
6. Zhao J, Zheng X, Chu H, Zhao J, Cong Y, Fried M, et al. A study of the methodological and clinical validity of the combined lactulose hydrogen breath test with scintigraphic oro-cecal transit test for diagnosing small intestinal bacterial overgrowth in IBS patients. Neurogastroenterol Motil. 2014 Jun;26(6):794–802.
7. Ghoshal UC, Shukla R, Ghoshal U. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut Liver. 2017;11(2):196–208. doi:10.5009/gnl16126
8. Gwee KA, Gonlachanvit S, Ghoshal UC, Chua ASB, Miwa H, Wu J, et al. Second Asian Consensus on Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2019 Jul 1;25(3):343–62.
9. Sachdeva S, Rawat AK, Reddy RS, Puri AS. Small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome: Frequency and predictors. Journal of Gastroenterology and Hepatology, 2011. 26: 135–138. doi:10.1111/j.1440-1746.2011.06654.x
10. Majewski M, Reddymasu SC, Sostarich S, et al. Efficacy of Rifaximin, a Nonabsorbed Oral Antibiotic, in the Treatment of Small Intestinal Bacterial Overgrowth. The American Journal of the Medical Sciences, 2007. 333(5), 266–270. doi:10.1097/maj.0b013e3180536784
11. Gupta K, Ghuman HS, Handa SV. Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile. Clin Med Insights Gastroenterol. 2017;10:1179552217728905. Published 2017 Aug 31. doi:10.1177/1179552217728905
12. Lauritano EC, Gabrielli M, Scarpellini E, et al. Small intestinal bacterial overgrowth recurrence after antibiotic therapy. Am J Gastroenterol. 2008;103(8):2031-5