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Turkish Journal of Medical Sciences

Abstract

Background/aim: This study aimed to identify small intestinal bacterial overgrowth (SIBO) in children and adolescents with persistent symptoms of duodenogastric reflux disease (DGRD).

Materials and methods: Patients aged 5–18 years who were diagnosed with DGRD between 2021 and 2023 were identified. Patients with two or more of 10 symptoms suggestive of SIBO (nausea, vomiting, weight loss, diarrhea, fatigue, joint pain, bloating, depression, acne rosacea, malnutrition) underwent lactulose hydrogen breath testing (LHBT).

Results: A total of 112 patients with DGRD were identified. Seven patients who could not be reached via the telemedicine method were excluded from the study. LHBT was not performed for 76 patients because they had one or fewer symptoms and nine patients did not want to participate in the study. Twenty children suspected of having SIBO were invited to the hospital. The most common SIBO symptoms in these patients were fatigue, nausea, and depression. SIBO positivity was assessed in two patients who exhibited an increase of ≥20 ppm in breath hydrogen measurements up to the 90th minute following basal breath tests and the ingestion of 15 mL of lactulose. Two patients diagnosed as having SIBO had normal control LHBT values after two doses of 10 mg/kg/day rifaximin treatment. Of the 17 patients with negative LHBT results, 12 received empirical rifaximin treatment (10 mg/kg twice daily) due to clinical symptoms suggestive of SIBO, and clinical improvement was achieved in 10 patients. Eighty-five percent of patients who received rifaximin experienced symptom normalization.

Conclusion: SIBO should be considered in children and adolescents with DGRD who have persistent symptoms, given that dysmotility is a common etiological factor.

Author ORCID Identifier

HATİCE YILMAZ DAĞLI: 0000-0003-3835-9775

ZAFER ŞAHİN: 0009-0001-1963-5634

DUDU DUYGU CİVAN: 0000-0002-8607-2042

REHA ARTAN: 0000-0001-6114-9210

AYGEN YILMAZ: 0000-0003-4051-8069

DOI

10.55730/1300-0144.6391

Keywords

adolescent, child, Duodenogastric reflux disease, hydrogen breath testing, rifaximin, small intestinal bacterial overgrowth

First Page

1462

Last Page

1469

Publisher

The Scientific and Technological Research Council of Türkiye (TÜBİTAK)

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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