{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:38:46Z","timestamp":1760243926395,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2010,7,26]],"date-time":"2010-07-26T00:00:00Z","timestamp":1280102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Functional gastrointestinal symptoms such us bloating, fullness, flatulence, diarrhea, and constipation due to irritable bowel syndrome (IBS) were recently attributed to small bowel bacterial overgrowth, a condition depending on the presence of an increased number of bacteria in the small bowel. However, the methodology used to describe this association may be harshly criticized, since it has already been shown to be quite inaccurate. As a result an inappropriate use of antibiotics was consequently generated. In fact, antibiotics could be effective in the treatment of functional complaints, but only in a limited subgroup of patients, characterized by an increase of fermentation at colonic level. In this review, we have examined the papers suggesting a pathophysiological link between IBS and small bowel bacterial overgrowth, underlining its inappropriateness, and put forth our personal view on the rationale for antibiotic use in IBS.<\/jats:p>","DOI":"10.3390\/ph3082380","type":"journal-article","created":{"date-parts":[[2010,7,26]],"date-time":"2010-07-26T10:36:08Z","timestamp":1280140568000},"page":"2380-2386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rational Use of Antibiotics in the Treatment of Functional Bowel Disorders"],"prefix":"10.3390","volume":"3","author":[{"given":"Michele Di","family":"Stefano","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Pavia, Foundation IRCCS S.Matteo Hospital, P.le C. Golgi 2, Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Fasulo","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pavia, Foundation IRCCS S.Matteo Hospital, P.le C. Golgi 2, Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gino Roberto","family":"Corazza","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pavia, Foundation IRCCS S.Matteo Hospital, P.le C. Golgi 2, Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2010,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1053\/j.gastro.2007.06.010","article-title":"Natural history of functional gastrointestinal disorders: a 12-year longitudinal population-based study","volume":"133","author":"Halder","year":"2007","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"582","DOI":"10.3109\/00365521003637211","article-title":"Societal costs for irritable bowel syndrome \u2013 a population based study","volume":"45","year":"2010","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1111\/j.1572-0241.2007.01540.x","article-title":"Comorbidity in Irritable Bowel Syndrome","volume":"102","author":"Whitehead","year":"2007","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1111\/j.1365-2036.2004.02250.x","article-title":"Comorbidity of irritable bowel syndrome in general practice: a Striking feature with clinical implications","volume":"20","author":"Vandvik","year":"2004","journal-title":"Aliment. Phrmacol. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1080\/00365520500442542","article-title":"Prevalence, comorbidity and impact of irritable bowel syndrome in Norway","volume":"41","author":"Vandvik","year":"2006","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_6","first-page":"16","article-title":"Symptoms in irritable bowel syndrome","volume":"79","author":"Dotevall","year":"1982","journal-title":"Scand. J. Gastroenterol. Suppl."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1111\/j.1572-0241.1999.01009.x","article-title":"Symptom and visceral perception in patients with pain-predominant irritable bowel syndrome","volume":"94","author":"Lembo","year":"1999","journal-title":"Am. J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1023\/A:1005554103531","article-title":"Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact","volume":"45","author":"Sandler","year":"2000","journal-title":"Dig. Dis. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1136\/bmj.2.6138.653","article-title":"Towards positive diagnosis of the irritable bowel","volume":"2","author":"Manning","year":"1978","journal-title":"Br. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1136\/bmj.299.6708.1138","article-title":"Ranking of symptoms by patients with irritable bowel syndrome","volume":"299","author":"Maxton","year":"1989","journal-title":"Br. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1136\/gut.27.1.37","article-title":"Non-colonic features of irritable bowel syndrome","volume":"27","author":"Whorwell","year":"1986","journal-title":"Gut"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1046\/j.1365-2036.2000.00808.x","article-title":"Non-absorbable antibiotics for managing intestinal gas production and gas related symptoms","volume":"14","author":"Strocchi","year":"2000","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1046\/j.1365-2036.2000.00751.x","article-title":"Rifaximin versus chlortetracycline in the short-term treatment of small intestine bacterial overgrowth","volume":"14","author":"Malservisi","year":"2000","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1046\/j.1365-2168.2000.01383-23.x","article-title":"Long-term symptomatic follow-up after Lind fundoplication","volume":"87","author":"Cameron","year":"2000","journal-title":"Br. J. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1053\/j.gastro.2005.12.036","article-title":"Impaired viscerosomatic reflexes and abdominal wall dystony associated with bloating","volume":"130","author":"Tremolaterra","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1053\/gast.2002.33658","article-title":"Prokinetic effects in patients with intestinal gas retention","volume":"122","author":"Caldarella","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"422","DOI":"10.7326\/0003-4819-124-4-199602150-00006","article-title":"The relation of passage of gas and abdominal bloating to colonic gas production","volume":"124","author":"Levitt","year":"1996","journal-title":"Ann. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0016-5085(99)70006-5","article-title":"Gastric wall tension determines perception of gastric distension","volume":"116","author":"Distrutti","year":"1999","journal-title":"Gastroenterology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0016-5085(79)91337-4","article-title":"Small intestine bacterial overgrowth","volume":"76","author":"King","year":"1979","journal-title":"Gastroenterology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/0016-5085(81)90150-5","article-title":"Small intestinal bacterial overgrowth syndrome","volume":"80","author":"Banwell","year":"1981","journal-title":"Gastroenterology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/0016-5085(90)90818-L","article-title":"The diagnosis of small bowel bacterial overgrowth","volume":"98","author":"Corazza","year":"1990","journal-title":"Gastroenterology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1111\/j.1572-0241.2000.03368.x","article-title":"Eradication of Small Intestinal Bacterial overgrowth Reduces Symptoms of irritable bowel syndrome","volume":"95","author":"Pimentel","year":"2000","journal-title":"Am. J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3109\/00365527909179892","article-title":"The lactulose breath test as diagnostic test for small-bowel bacterial overgrowth","volume":"14","author":"Rhodes","year":"1979","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1016\/0016-5085(90)91216-S","article-title":"Lactulose hydrogen breath test in the diagnosis of bacterial overgrowth","volume":"99","author":"Rhodes","year":"1990","journal-title":"Gastroenterology"},{"key":"ref_25","first-page":"1795","article-title":"The lactulose breath hydrogen test and small intestinal bacterial overgrowth","volume":"91","author":"Riordan","year":"1996","journal-title":"Am. J. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/0016-5085(90)91339-8","article-title":"Glucose-H2 breath test for small intestine bacterial overgrowth","volume":"98","author":"Corazza","year":"1990","journal-title":"Gastroenterology"},{"key":"ref_27","first-page":"137","article-title":"Metronidazole relieves symptoms in irritable bowel syndrome: the confusion with so-called \u201cchronic amebiasis\u201d","volume":"16","author":"Nayak","year":"1997","journal-title":"Indian. J. Gastroenterol."},{"key":"ref_28","first-page":"412","article-title":"Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. A double-blind, randomized, placebo-controlled study","volume":"98","author":"Pimentel","year":"2003","journal-title":"Am. J. Gastroenterol."},{"key":"ref_29","first-page":"139","article-title":"Results of small intestinal bacterial overgrowth testing in irritable bowel syndrome patients: clinical profiles and effect of antibiotic trial","volume":"52","author":"Majewsky","year":"2007","journal-title":"Adv. Med. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1136\/gut.2006.108712","article-title":"Small intestinal bacterial overgrowth in patients with irritable bowel syndrome","volume":"56","author":"Posserud","year":"2007","journal-title":"Gut"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1046\/j.1365-2036.2002.01305.x","article-title":"Clinical perspectives, mechanisms, diagnosis and management of irritable bowel syndrome","volume":"16","author":"Camilleri","year":"2002","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1053\/j.gastro.2005.06.062","article-title":"Abdominal bloating","volume":"129","author":"Azpiroz","year":"2005","journal-title":"Gastroenterology"}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/3\/8\/2380\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T22:03:00Z","timestamp":1760220180000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/3\/8\/2380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,7,26]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2010,8]]}},"alternative-id":["ph3082380"],"URL":"https:\/\/doi.org\/10.3390\/ph3082380","relation":{},"ISSN":["1424-8247"],"issn-type":[{"type":"electronic","value":"1424-8247"}],"subject":[],"published":{"date-parts":[[2010,7,26]]}}}