(Adnkronos) - Un’abnorme crescita di batteri (Bacterial Overgrowth) nel piccolo intestino (small intestinal) "è ciò che caratterizza la Sibo, quadro patologico tanto diffuso quanto sottostimato, ovvero confuso con la Sindrome del colon irritabile o, più frequentemente, con la malattia da reflusso gastro-esofageo. Diversi i fattori di rischio che possono favorire l’insorgenza di questa condizione morbosa, dalla chirurgia bariatrica, alle insane abitudini alimentari, dallo stress cronico all’assunzione continuativa dei cosiddetti 'protettori gastrici'". Così l’immunologo Mauro Minelli introduce la settima puntata del format 'Igea - la medicina dal mito all'intelligenza artificiale'.
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00:00The more and more profound knowledge of the complex microbiota-intestinal universe has opened the way to diagnosis for certain unprecedented cases,
00:24which, on the one hand, force doctors to acquire new awareness on which to re-impose more targeted and effective therapies, on the other, precisely because of their originality, risk remaining largely unknown, if not totally ignored.
00:39Yet, the bacterial flora of the intestine, which, when unbalanced, is an important co-artifact of our well-being, can become responsible for various problems in cases in which that balance, for some reason, should be lost.
00:53SIBO is a very widespread pathological condition characterized by an increased concentration of bacteria in the intestine.
01:02In fact, the term SIBO is nothing more than an acronym for Small Intestinal Bacterial Overgrowth, a condition in which an overgrowth of bacteria in the small intestine, that is, in the thin intestine, is often associated with a situation of malabsorption.
01:25For an increased permeability of that tract of the intestine, on the clinical level, SIBO is characterized mainly by a marked condition of abdominal swelling, which in turn is often associated with flatulence, morning dizziness, constipation or diarrhea, or more often alternation of constipation and diarrhea, and still pain, an intense pain that is usually felt in the right quadrant of the abdomen.
01:55Then there is also a reflexive phenomenology with tachycardia, with raclase, that is, this dry cough that is caused by a sort of constant constipation, constipation in the throat, and still dysphonia, that is, lowering of the voice, raucedness, dysphagia, that is, impediment, difficulty in swallowing, metallic taste, alitosis.
02:20Often, moreover, these symptoms are also associated with disorders of absorption, absorptive deficits, therefore vitamin deficiency, for example B12 or B9 or D3, and therefore also anemic state due to lack of iron and still anomalies of the anus, hair, nails, osteoporosis, weight loss, muscle weakness.
02:47SIBO, in addition to intestinal pathological quadri, such as celiac disease, SNAS or diverticulosis, is frequently associated with surgical practices, such as gastric resections, post-surgical adherence, ileocolic resections with the elimination of the ileocecal valve, gastrointestinal bypasses and any alteration of the normal intestinal structure and function.
03:13But the most frequent cause of SIBO is certainly represented by a continuous intake of drugs belonging to the category of the so-called proton pump inhibitors, more commonly known as gastric protectors.
03:29It should be remembered that these drugs are able to inhibit the production of hydrochloric acid and are often taken by patients for a very long time, almost that hydrochloric acid was an option, it was the production of something that the body has decided to produce even if it was not necessary.
03:48Hydrochloric acid has a very important function as it prevents food from being digested, that is, it diminishes the food that will then be digested and will continue their journey in the various phases of digestion.
04:02Now, if this process is inhibited, what happens is that the indigested food reaches the intestinal bacteria that are most at risk and which, receiving the indigested food, especially if FODMAP, that is, if it is fermentable, will produce fermentation with all the consequences that this fermentation can generate and that we have previously pointed out.
04:25Among other drugs that can contribute to the insurgence of SIBO, I remember antibiotics when they obviously had to be taken continuously, antibiotics that we know are able to profoundly alter the composition of the intestinal microbiota.
04:42And still the antispastics that are often self-supplied in the case, for example, of the irritable bowel, antispastics that, by blocking the peristaltic action of the intestine, slow down the intestinal transit, favoring the action of fermentative bacteria.
04:59And then I still remember the states of anxiety as a possible cause of SIBO, as in the states of anxiety an altered production of serotonin is determined, which is important for regulating the intestinal transit, and, last note, I would like to reserve it for a nutrition that is practically free of fiber.
05:21It is essential to temporarily deal with SIBO, since untreated cases can lead to long-term complications and nutritional deficiencies. The correct treatment of SIBO necessarily involves the setting up of therapeutic protocols aimed at reducing the excessive growth of bacteria, along with changes in the diet to support the health of the intestine.
05:44The diagnosis of SIBO is based on the breath test, that is, a breath test that allows to measure the amount of hydrogen and methane gas produced by the intestinal fermentative bacteria, as well as a test of intestinal permeability conducted correctly.
06:02Of course, a test that is carried out on a urinary matrix can allow a correct diagnosis. I say immediately that the diagnosis is essential because it is from the correct diagnosis that an equally correct therapy comes out, a therapy that, in the case of SIBO, obviously, cannot be based on the use of gastric protectors that, rather than curing the pathology, tend to induce it.
06:28So, the diagnosis, I repeat, is essential, also because it is necessary to keep in mind that the acid produced by the bacteria that tends to generate reflux phenomena is sulfhydric acid and not chloride acid, and on the sulfhydric acid, the gastric protectors have no effect. So, watch out for the diagnosis, because it is from this that a therapy can derive, really able to stabilize the pathology.
06:58For more information, visit www.fema.gov
07:28www.fema.gov