IBS和SIBO：肠道微生物群、病理生理学和非药物干预
IBS and SIBO: Gut Microbiota, Pathophysiology, and Non-Pharmacological Interventions.
摘要(中文译文)
肠易激综合征（IBS）与小肠细菌过度生长（SIBO）共有腹痛、腹胀及排便习惯改变等症状，二者均与菌群失调和脑-肠轴功能障碍相关。IBS是一种多因素疾病，以动力异常、内脏高敏感、低度炎症及微生物群改变为特征。相比之下，SIBO定义为小肠内细菌过度定植，可模拟或加重IBS症状。肠道微生物及其代谢产物影响动力、免疫激活、屏障完整性及气体产生；产甲烷菌过度生长与便秘型表现相关，而产氢及硫化氢相关通路可能促进腹泻和腹胀。由于反复或经验性使用抗生素较为常见——尤其是在疑似SIBO时——却带来耐药、微生物群破坏和复发风险，因此优先采用有效的非抗生素策略具有充分理由。据此，本综述综合了当前关于IBS/SIBO病理生理学及微生物群相互作用的证据，评估了非药物干预措施，包括饮食方法、益生菌/益生元、草药疗法及心身治疗（如认知行为疗法和肠道导向催眠疗法）。我们强调一个整合性框架，在支持症状控制和生活质量的同时，有助于减少不必要的抗生素暴露。
Abstract
Irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) share symptoms such as abdominal pain, bloating, and altered bowel habits. Both are linked to dysbiosis and gut-brain axis dysfunction. IBS is a multifactorial disorder characterized by abnormal motility, visceral hypersensitivity, low-grade inflammation, and alterations in the microbiota. In contrast, SIBO is defined by excessive bacterial colonization of the small intestine that can mimic or worsen IBS symptoms. Gut microbes and their metabolites influence motility, immune activation, barrier integrity, and gas production; methanogen overgrowth is associated with constipation-predominant presentations, while hydrogen- and hydrogen sulfide-related pathways may contribute to diarrhea and bloating. Because recurrent or empiric antibiotic use is common-particularly in suspected SIBO-yet carries risks of resistance, microbiome disruption, and relapse, there is a strong rationale to prioritize effective non-antibiotic strategies. Accordingly, this review synthesizes current evidence on IBS/SIBO pathophysiology and microbiota interactions. It evaluates non-pharmacological interventions including dietary approaches, probiotics/prebiotics, herbal therapies, and mind-body treatments (e.g., cognitive behavioral therapy and gut-directed hypnotherapy). We emphasize an integrative framework that supports symptom control and quality of life while helping reduce unnecessary antibiotic exposure.
如何引用
AMA
Jelena Šuran, Nikola Pavlović, Joško Božić, Marko Kumrić, Katarina Vukojević, Natalija Filipović, et al. IBS and SIBO: Gut Microbiota, Pathophysiology, and Non-Pharmacological Interventions.. Antibiotics (Basel, Switzerland). 2026; doi:10.3390/antibiotics15030251.
APA
Jelena Šuran, Nikola Pavlović, Joško Božić, Marko Kumrić, Katarina Vukojević, Natalija Filipović, et al (2026). IBS and SIBO: Gut Microbiota, Pathophysiology, and Non-Pharmacological Interventions.. Antibiotics (Basel, Switzerland). https://doi.org/10.3390/antibiotics15030251
GB/T 7714
Jelena Šuran, Nikola Pavlović, Joško Božić, Marko Kumrić, Katarina Vukojević, Natalija Filipović, et al. IBS and SIBO: Gut Microbiota, Pathophysiology, and Non-Pharmacological Interventions.[J]. Antibiotics (Basel, Switzerland), 2026 doi:10.3390/antibiotics15030251.
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