Small intestinal bacterial overgrowth: could it be associated with chronic abdominal pain in children with allergic diseases?

Rev Esp Enferm Dig. 2019 Dec;111(12):927-930. doi: 10.17235/reed.2019.6321/2019.


Background and aims: small intestinal bacterial overgrowth (SIBO) is a well-known cause of chronic abdominal pain (CAP) during the pediatric age. On the other hand, children with a history of some allergic disorder present CAP more frequently. The aim of this study was to determine the association between the presence of allergic diseases and SIBO in patients diagnosed with CAP.

Materials and methods: this was an observational, analytical, retrospective study. Children with CAP who had undergone a lactulose hydrogen breath test to determine the presence of SIBO were included in the study. All patients underwent an evaluation for allergies by means of a skin prick test or the determination of specific IgE, according to clinical diagnosis. The study groups were established according to the presence of SIBO and the results of the allergic evaluation were statistically compared between the groups.

Results: seventy patients were included (41 females and 29 males) and SIBO was diagnosed in 35 patients. In addition, 71.4% of children with SIBO were found to have an allergic disease, in contrast with 28.6% of children without SIBO (p = 0.001). The odds ratio for having any type of allergy in patients with SIBO was 5.45 (95% CI, 1.96-15.17; p = 0.001).

Conclusions: we found an association between SIBO and allergic disease, especially allergic rhinitis, cow's milk protein allergy and asthma. Thus, SIBO should be ruled out in pediatric patients with CAP and allergic disease.

Publication types

  • Observational Study

MeSH terms

  • Abdominal Pain / etiology*
  • Adolescent
  • Asthma / complications
  • Asthma / diagnosis
  • Bacteria / growth & development*
  • Breath Tests / methods
  • Child
  • Child, Preschool
  • Chronic Pain / etiology*
  • Female
  • Gastrointestinal Agents / administration & dosage
  • Gastrointestinal Microbiome*
  • Humans
  • Hypersensitivity / complications*
  • Hypersensitivity / diagnosis
  • Intestine, Small / microbiology*
  • Lactulose / administration & dosage
  • Male
  • Milk Hypersensitivity / complications
  • Milk Hypersensitivity / diagnosis
  • Odds Ratio
  • Retrospective Studies
  • Rhinitis, Allergic / complications
  • Rhinitis, Allergic / diagnosis


  • Gastrointestinal Agents
  • Lactulose