Work

Prevalence and association of small intestinal bacterial overgrowth with functional gastrointestinal disorders in children: A systematic review and meta-analysis

Year: 2025

Type: review

Abstract: Small intestinal bacterial overgrowth (SIBO) has been implicated in the pathophysiology of functional gastrointestinal disorders (FGIDs), yet its prevalence and clinical relevance in children remain unclear. This systematic review and meta-analysis aimed to estimate the pooled prevalence of SIBO in pediatric FGIDs and assess its association with specific FGID subtypes. A comprehensive search of PubMed, Embase, Scopus, Web of Science, and Cochrane Library was conducted from inception to May 2025 for observational studies involving children (≤18 years) with FGIDs evaluated for SIBO using standardized diagnostic methods. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses were performed by FGID subtype, diagnostic modality (glucose vs. lactulose breath test), and dominant gas type (hydrogen vs. methane). Risk of bias was assessed using JBI tools; publication bias was evaluated using Begg’s and Egger’s tests. Fourteen studies comprising 2,459 children were included. The pooled prevalence of SIBO among children with FGIDs was 33.2% (95% CI: 26.8%–40.3%; I 2 = 76.5%). Compared to controls, children with FGIDs had a significantly higher likelihood of SIBO (OR = 4.06, 95% CI: 2.51–6.56). The highest prevalence was observed in irritable bowel syndrome (38.5%) and functional constipation (28.7%). Methane-dominant SIBO was notably associated with constipation-predominant FGIDs. No significant publication bias was identified. SIBO is common in pediatric FGIDs, particularly in IBS and constipation subtypes, supporting its consideration in diagnostic and therapeutic strategies for affected children.

Source: Gastroenterology & Endoscopy

DOI: 10.1016/j.gande.2025.09.001

Authors: Hamidreza Zivarifar, Fatemeh Sadat Hashemi Javaheri, Nawfal R. Hussein, Masoud Keikha

Institutions: Zahedan University of Medical Sciences, Mashhad University of Medical Sciences, University of Zakho, Iranshahr University

Language: English

Topic: Gastrointestinal motility and disorders

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $700