Helicobacter pylori infection and small intestinal bacterial overgrowth–more than what meets the eye

doi:10.12998/wjcc.v10.i21.7209

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World Journal of Clinical Cases

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World J Clin Cases. Jul 26, 2022; 10(21): 7209-7214
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7209

Helicobacter pylori infection and small intestinal bacterial overgrowth–more than what meets the eye

Murali Dharan, David Wozny

Murali Dharan, Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States

David Wozny, Department of Primary Care and Internal Medicine, University of Connecticut, Farmington, CT 06030, United States

Author contributions: Dharan M contributed to the conceptualization, literature search, drafting of article and major revisions; Wozny D contributed to the literature search, drafting of article and revision.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Murali Dharan, FASGE, MRCP, Assistant Professor, Department of Gastroenterology and Hepatology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, United States. dharan@uchc.edu

Received: January 14, 2022
Peer-review started: January 14, 2022
First decision: March 8, 2022
Revised: April 18, 2022
Accepted: June 14, 2022
Article in press: June 14, 2022
Published online: July 26, 2022
Processing time: 177 Days and 9.6 Hours

Abstract

Helicobacter pylori (H. pylori) infection is very common and affects a significant proportion of the world population. In contrast, the prevalence of small intestinal bacterial overgrowth (SIBO) in the general population is not well understood. There can be coexistence of both disease states in a given patient and their clinical symptoms may also overlap with one and another. There is no clear clinical guidelines for testing for and treating SIBO in patients with H. pylori infection. This review article explores the available evidence on the relationship between H. pylori infection and SIBO, diagnosis and treatment of these entities and also comments on associated non-gastrointestinal conditions.

Keywords: Helicobacter pylori infection; Small intestinal bacterial overgrowth; Overlap; Diagnosis; Treatment

Core Tip: This article explores the coexistence of small intestinal bacterial overgrowth (SIBO) in patients with Helicobacter pylori (H. pylori) infection including epidemiology and pathophysiologic mechanisms. It also reviews diagnosis and treatment of these entities and highlights current knowledge gaps and areas of future research. Currently, there are no guidelines for evaluation and management of co-existent SIBO in H. pylori infection.