Asian-Pacific consensus on small intestinal bacterial overgrowth in gastrointestinal disorders: An initiative of the Indian Neurogastroenterology and Motility Association

• DOI: 10.1007/s12664-022-01292-x
• Publication Date: 2022-10-10T12:42:31Z
• Authors: Uday C. Ghoshal; Sanjeev Sachdeva; Ujjala Ghoshal; Asha Misra; Amarender Singh Puri; Nitesh Pratap; Ayesha Shah; M. Masudur Rahman; Kok Ann Gwee; Victoria P Y Tan; Tahmeed Ahmed; Yeong Yeh Lee; B S Ramakrishna; Rupjyoti Talukdar; S V Rana; Saroj K Sinha; Minhu Chen; Nayoung Kim; Gerald Holtmann
• Keywords: 0301 basic medicine; Asian-Pacific Consensus; Gastrointestinal Diseases; Gastroenterology; Hirschsprung Disease and Enteric Nervous System Development; Intestinal Malrotation and Obstruction Disorders; Guideline; Functional Bowel Disorders and Gastrointestinal Health; Small intestinal bacterial overgrowth; 16. Peace & justice; 3. Good health; Irritable Bowel Syndrome; Irritable bowel syndrome; 03 medical and health sciences; Breath Tests; Intestine, Small; Health Sciences; Pathology; Humans; Medicine; Surgery; Intensive care medicine; Internal medicine; Intestinal Permeability

AbstractIn the clinical setting, small intestinal bacterial overgrowth (SIBO) is a frequent, but under-diagnosed entity. SIBO is linked to various gastrointestinal (GI) and non-GI disorders with potentially significant morbidity. The optimal management of SIBO is undefined while there is a lack of published consensus guidelines. Against this background, under the auspices of the Indian Neurogastroenterology and Motility Association (INMA), formerly known as the Indian Motility and Functional Diseases Association (IMFDA), experts from the Asian-Pacific region with extensive research and clinical experience in the field of gut dysbiosis including SIBO developed this evidence-based practice guideline for the management of SIBO utilizing a modified Delphi process based upon 37 consensus statements, involving an electronic voting process as well as face-to-face meetings and review of relevant supporting literature. These statements include 6 statements on definition and epidemiology; 11 on etiopathogenesis and pathophysiology; 5 on clinical manifestations, differential diagnosis, and predictors; and 15 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservations was 80% or higher, the statement was regarded as accepted. The members of the consensus team consider that this guideline would be valuable to inform clinical practice, teaching, and research on SIBO in the Asian-Pacific region as well as in other countries.